Individual provider Active NPI

Mihir A Kshirsagar, DO

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1215429824
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61164736 Issued in WA
Practice address
747 Broadway
Seattle, WA 98122-4379
Phone
(206) 215-2520
Fax
(206) 386-3180
NPI assigned
May 31, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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 OP61164736 WA Primary

Addresses

Primary practice location

747 Broadway
Seattle, WA 98122-4379

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1215429824MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230407000581 CA Practitioner - Family Practice 5799189254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of MontereyGroup PAC ID 2466345632, 186 clinicians

Practice addresses (Care Compare)

1270 Natividad Rd
Salinas, CA 93906-3144

1270 Natividad Rd
146.38
Salinas, CA 93906-3198

1441 Constitution Blvd
Salinas, CA 93906-3100

1441 Constitution Blvd
Salinas, CA 93912
Phone (831) 755-4235

1615 Bunker Hill Way
Suite 100
Salinas, CA 93906-6010

PO Box
Suite 80007
Salinas, CA 93912

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Monterey Current Accepting new patients
County of Monterey Family Medicine CurrentSince Dec 14, 2022 Accepting new patients
County of Monterey Behavioral Health CurrentSince Dec 14, 2022 Accepting new patients
County of Monterey Family Medicine Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

467 El Camino Real
Greenfield, CA 93927
Phone (831) 674-0112

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1215429824",
    "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": "747 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224379",
            "telephone_number": "206-215-2520",
            "fax_number": "206-386-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KSHIRSAGAR",
        "first_name": "MIHIR",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61164736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215429824",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.