Individual provider Active NPI

Sara Talal Muhtaseb, PA-C

  • Physician Assistant
  • Longview, WA
National Provider Identifier
1174331466
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61646078 Issued in WA
Practice address
1152 Douglas St
Longview, WA 98632-2452
Phone
(760) 681-3444
Fax
(844) 697-8702
NPI assigned
Dec 19, 2024
Last updated
Mar 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61646078 WA Primary

Addresses

Primary practice location

1152 Douglas St
Longview, WA 98632-2452

Mailing address

43575 Mission Blvd Ste 716
Fremont, CA 94539-5831
Phone (360) 940-0880

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250401003275 WA Practitioner - Physician Assistant 0749703650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbia Medical PLLCGroup PAC ID 0840630109, 5 clinicians

Practice addresses (Care Compare)

1152 Douglas St
Longview, WA 98632-2452
Phone (360) 940-0880

1700 116TH Ave NE
FL 2
Bellevue, WA 98004-3066
Phone (425) 209-0840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy & Asthma Center of SW Washington LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1174331466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43575 MISSION BLVD STE 716",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945395831",
            "telephone_number": "360-940-0880",
            "fax_number": "844-697-8702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1152 DOUGLAS ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322452",
            "telephone_number": "760-681-3444",
            "fax_number": "844-697-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUHTASEB",
        "first_name": "SARA",
        "middle_name": "TALAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-19",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61646078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.