NPIMap

Individual provider Active NPI

Shiv Mohini, M.D.

  • Internal Medicine Physician
  • Vancouver, WA
National Provider Identifier
1174977177
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD61142231 Issued in WA
Practice address
700 NE 87TH Ave
Vancouver, WA 98664-4896
Phone
(360) 882-2778
NPI assigned
Apr 16, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X S2424 TX
Internal Medicine Physician 207R00000X MD61142231 WA Primary

Addresses

Primary practice location

700 NE 87TH Ave
Vancouver, WA 98664-4896

Mailing address

PO Box 4825
Portland, OR 97208-4825
Phone (360) 882-2778

Other practice location 1

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-5240

Other practice location 2

1201 W Frank Ave
Lufkin, TX 75904-3357
Phone (936) 631-6789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191118001127 TX Practitioner - Internal Medicine 8224375712 Reassigns benefits to 2 organizations
I20210504001622 WA Practitioner - Internal Medicine 8224375712 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Jul 26, 2021 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Jul 26, 2021 Accepting new patients
South Sound Inpatient Physicians, PLLC Internal Medicine CurrentSince Apr 2, 2021 Accepting new patients
The Vancouver Clinic Inc PS Internal Medicine Current Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Apr 2, 2021 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Legacy Salmon Creek Hospital Past Accepting new patients
Peacehealth Past Accepting new patients

Locations

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

1007 S William St
Atlanta, TX 75551
Phone (903) 614-2000

600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

1201 W Frank Ave
Lufkin, TX 75904
Phone (936) 634-8111

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

Organizations & group practices 10

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 4

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": "1460764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1174977177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084825",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Adams St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102306",
            "country_code": "US",
            "telephone_number": "315-464-5240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 W Frank Ave",
            "address_purpose": "LOCATION",
            "city": "Lufkin",
            "state": "TX",
            "postal_code": "759043357",
            "country_code": "US",
            "telephone_number": "936-631-6789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHINI",
        "first_name": "SHIV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S2424",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61142231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.