NPIMap

Individual provider Active NPI

Humera Ali, MD

  • Interventional Cardiology Physician
  • Issaquah, WA
National Provider Identifier
1174587950
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD00036691 Issued in WA
Practice address
751 NE Blakely Dr Ste 3020
Issaquah, WA 98029-6201
Phone
(206) 861-8550
Fax
(206) 861-8551
NPI assigned
Apr 17, 2006
Last updated
Dec 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD00036691 WA
Interventional Cardiology Physician 207RI0011X MD00036691 WA Primary

Addresses

Primary practice location

751 NE Blakely Dr Ste 3020
Issaquah, WA 98029-6201

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 2

IdentifierTypeStateIssuer
8232027MedicaidWA
1004126MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050322001139 WA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 4981650033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 7517870645, 79 clinicians

Practice addresses (Care Compare)

751 NE Blakely Dr
Suite 3020
Issaquah, WA 98029-6201
Phone (206) 861-8550

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Current Accepting new patients
Swedish Health Services Cardiovascular Disease CurrentSince Sep 12, 2022 Accepting new patients
Swedish Health Services Cardiovascular Disease CurrentSince Sep 12, 2022 Accepting new patients
The Polyclinic PLLC CurrentSince Aug 1, 2006 Accepting new patients
Swedish Health Services Past Accepting new patients
Bellevue Cardiology Clinic PLLC Cardiovascular Disease Past Accepting new patients

Locations

12917 SE 38th St
Ste 100
Bellevue, WA 98006
Phone (206) 292-7990

7320 216th St SW
Ste 210
Edmonds, WA 98026
Phone (206) 292-7990

751 NE Blakely Dr
Ste 3020
Issaquah, WA 98029
Phone (425) 313-5345

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

500 17th Ave
Seattle, WA 98122
Phone (206) 320-2111

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

1145 Broadway
Seattle, WA 98122

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1174587950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR STE 3020",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "206-861-8550",
            "fax_number": "206-861-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "HUMERA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00036691",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD00036691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8232027",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004126",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.