Individual provider Active NPI

Ramin Baimaninejad, MD

  • Family Medicine Physician
  • Mukilteo, WA
National Provider Identifier
1194307454
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61467654 Issued in WA
Practice address
4112 Harbour Pointe Blvd SW Ste 100
Mukilteo, WA 98275-5457
Phone
(425) 347-6330
NPI assigned
Apr 26, 2021
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61467654 WA Primary

Addresses

Primary practice location

4112 Harbour Pointe Blvd SW Ste 100
Mukilteo, WA 98275-5457

Mailing address

4112 Harbour Pointe Blvd SW Ste 100
Mukilteo, WA 98275-5457
Phone (425) 347-6330

Other practice location 1

9710 State Ave
Marysville, WA 98270-2232
Phone (360) 653-1742

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
I20230523001803 WA Practitioner - Family Practice 8628434321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4112 Harbour Pointe Blvd SW
Suite 100
Mukilteo, WA 98275-5457
Phone (425) 347-6330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61467654WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Oct 21, 2024 Accepting new patients
Sea Mar Community Health Centers Family Medicine CurrentSince Jan 13, 2023 Accepting new patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
Providence Health & Services - Washington Family Medicine CurrentSince Oct 21, 2024 Accepting new patients
Sea Mar Community Health Centers CurrentSince Jan 13, 2023 Accepting new patients

Locations

9710 State Ave
Marysville, WA 98270
Phone (360) 653-1742

17707 W Main St
Fl 1
Monroe, WA 98272
Phone (360) 282-3885

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

Interoperability endpoints

  • Direct secure messaging: rbaimaninejad1061823@wm.providencedirect.org
  • Direct secure messaging: rbaimaninejad489210@direct.multicare.org

Organizations & group practices 5

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 2

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": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1194307454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 HARBOUR POINTE BLVD SW STE 100",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755457",
            "telephone_number": "425-347-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 HARBOUR POINTE BLVD SW STE 100",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755457",
            "telephone_number": "425-347-6330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9710 State Ave",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "WA",
            "postal_code": "982702232",
            "country_code": "US",
            "telephone_number": "360-653-1742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAIMANINEJAD",
        "first_name": "RAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-26",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61467654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

Verify at the official NPI Registry.