Hamed A Al-Ghanim, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00044399 Issued in WA

Practice address

3927 Rucker Ave
Everett, WA 98201-4833

Phone

(425) 259-0966

NPI assigned

Aug 10, 2006

Last updated

Jun 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Specialty

Family Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: halghanim3235@direct.tecmc.com
• FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4

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

• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766

  Family Medicine

  Medicare reassignment Care Compare group NPD
• The Polyclinic PLLC

  dba Optum - Broadway

  • Audiologist
  • Seattle, WA
  • NPI 1174594634

  Family Medicine

  Medicare reassignment NPD
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425

  Family Medicine

  NPD
• The Polyclinic

  • Ambulatory Surgical Clinic/Center
  • Seattle, WA
  • NPI 1073944039
  NPD
• The Polyclinic PLLC

  dba Optum Tacoma

  • Durable Medical Equipment & Medical Supplies
  • Tacoma, WA
  • NPI 1831411487

  Family Medicine

  NPD
• Providence Health & Services-Wa

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Everett, WA
  • NPI 1033360144
  NPD (past)
• HCA Healthone LLC

  dba HCA HealthONE Swedish Hospital

  • General Acute Care Hospital
  • Englewood, CO
  • NPI 1396790200
  NPD (past)
• Modesto Advanced Diagnostic Imaging Medical Center

  • Diagnostic Radiology Physician
  • Patterson, CA
  • NPI 1538389234
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1124039938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-259-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-GHANIM",
        "first_name": "HAMED",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00044399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8433773",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002936",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MD00044399",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORK COMP",
            "identifier": "200254",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8907038",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hee Yung Kim Akins, LMHC
• Walter Akwo
• Saleh Al Kathiri
• Ahmed M Al Salihi Sr.
• Melissa Al-Ahmadi, MSW
• Shahad Al-Mansuri
• Ali Al-Salman
• Elaf Imad Al-Turfy
• Aisha Alam, M.D.
• Lindsy J Alanis, MD

• Family Medicine Physician in Everett, WA
• Providers in Everett, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.