Active NPI
Sholeh Bagheri, M.D.
- Pulmonary Disease Physician
- Longview, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- MD00047589
- Practice address
- 1615 Delaware St
Longview, WA 98632-2310 - Phone
- (360) 414-2730
- Fax
- (360) 414-2739
- NPI assigned
- Aug 31, 2006
- Last updated
- Feb 5, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 216509 | NY | |
| Internal Medicine Physician | 207R00000X | MD00047589 | WA | |
| Pulmonary Disease Physician | 207RP1001X | MD00047589 | WA | Primary |
Addresses
Primary practice location
1615 Delaware St
Longview, WA 98632-2310
Mailing address
PO Box 3002
Longview, WA 98632-0302
Phone (360) 414-2048
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8477382 | Medicaid | WA | |
| P00392543 | Other | RAILROAD MEDICARE | |
| 0219444 | Other | WA | LABOR & INDUSTRIES |
| 02529362 | Medicaid | NY | |
| 8944123 | Other | WA | CRIME VICTIMS |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- State University of New York Downstate Medical Center, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
16811 SE McGillivray Blvd
Vancouver, WA 98683-3404
Phone (360) 735-8100
505 NE 87TH Ave
Vancouver, WA 98664-1965
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 216509 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Current | Accepting new patients | |
| Sotirios Kassapidis M.D, P.C | Pulmonary Disease | Past | Accepting new patients |
Locations
1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818
1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253
1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100
505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854
Interoperability endpoints
- sbagheri25563@direct.peacehealth.org
Organizations & group practices 2
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.
-
- Pulmonary Disease Physician
- Astoria, NY
- NPI 1891818431
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba PeaceHealth SW Heart & Vascular Center
- Cardiovascular Disease Physician
- Vancouver, WA
- NPI 1003194911
Hospital
-
dba PeaceHealth Southwest Medical Center
- General Acute Care Hospital
- Vancouver, WA
- NPI 1134178999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202169600000",
"number": "1285746875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3002",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986320302",
"telephone_number": "360-414-2048",
"fax_number": "360-575-6749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 DELAWARE ST",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322310",
"telephone_number": "360-414-2730",
"fax_number": "360-414-2739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGHERI",
"first_name": "SHOLEH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2008-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "216509",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00047589",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "WA",
"license": "MD00047589",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8477382",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00392543",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0219444",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02529362",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8944123",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.