Moustapha Dimachk, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD61595905 Issued in WA

Practice address

380 Chase Ave
Walla Walla, WA 99362-2924

Phone

(095) 897-3790

Fax

(509) 897-5558

NPI assigned

Jul 27, 2015

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

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

General Surgery

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services - WashingtonGroup PAC ID 2860552973, 266 clinicians

Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002
• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058

Merit-based Incentive Payment System (MIPS)

Final score

96.26 of 100Reported as apm

Quality

84.3

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Washington

  • Family Medicine Physician
  • Walla Walla, WA
  • NPI 1922259738

  Surgery

  Medicare reassignment Care Compare group NPD
• Kadlec Regional Medical Center

  • Clinic/Center
  • Kennewick, WA
  • NPI 1063967933
  NPD
• Kadlec Regional Medical Center

  • Rehabilitation Hospital Unit
  • Richland, WA
  • NPI 1790319580
  NPD
• Providence Health & Services - Washington

  • Radiation Oncology Physician
  • Walla Walla, WA
  • NPI 1982856886
  NPD
• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  NPD (past)

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

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation
• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  Care Compare affiliation

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1215312772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 CHASE AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622924",
            "telephone_number": "095-897-3790",
            "fax_number": "509-897-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 CHASE AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622924",
            "telephone_number": "095-897-3790",
            "fax_number": "509-897-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMACHK",
        "first_name": "MOUSTAPHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-27",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD61595905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merridy R. Dickey, LICSW
• Rebekah Dickman, M.D.
• Carrie S Diede, M.S., CCC-SLP
• Jill Kathleen Diego, RN
• Sharyl M Dill, LP00012610
• Laura Marie Dixson, MSW, LICSW
• DNS Group LLC
• Dorothy Doebler, MED
• Donald C. Bassham D.D.S. P.S.
• Catherine Jane Donaldson, MD

• Surgery Physician in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.