Individual provider Active NPI

Mehrdad Khalighi

  • Internal Medicine Physician
  • Tacoma, WA
National Provider Identifier
1114986619
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00044013 Issued in WA
Practice address
9601 Steilacoom Blvd SW
Tacoma, WA 98498-7213
Phone
(253) 582-8900
Fax
(253) 756-2879
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00044013 WA Primary

Addresses

Primary practice location

9601 Steilacoom Blvd SW
Tacoma, WA 98498-7213

Mailing address

9601 Steilacoom Blvd SW
Tacoma, WA 98498-7213
Phone (253) 582-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050802000420 WA Practitioner - Family PracticePractitioner - Geriatric Medicine 3971531799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Karmel Medical Clinic, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Department of Social Dept of SHS Div of Instns Past Accepting new patients
Key Bridge Medical Clinic LLC Past Accepting new patients

Locations

11318 Bridgeport Way SW
Ste A
Lakewood, WA 98499
Phone (253) 380-8905

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1114986619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 STEILACOOM BLVD SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984987213",
            "telephone_number": "253-582-8900",
            "fax_number": "253-756-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 STEILACOOM BLVD SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984987213",
            "telephone_number": "253-582-8900",
            "fax_number": "253-756-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIGHI",
        "first_name": "MEHRDAD",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00044013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.