NPIMap

Individual provider Active NPI

Priyanka Shah O'Brien, M.D.

  • Otolaryngology Physician
  • Longview, WA
National Provider Identifier
1326306317
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD60840702 Issued in WA
Practice address
1801 1St Ave Ste 3a
Longview, WA 98632-3271
Phone
(360) 636-4469
NPI assigned
Apr 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 270776 MA
Otolaryngology Physician 207Y00000X MD60840702 WA Primary

Addresses

Primary practice location

1801 1St Ave Ste 3a
Longview, WA 98632-3271

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-2000

Other practice location 1

299 Faunce Corner Rd Fl 2
North Dartmouth, MA 02747-1218
Phone (508) 973-1550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180725002685 WA Practitioner - Otolaryngology 0840592838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Wayne State University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 5890689293, 188 clinicians
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 636-4814

1660 Delware St
Longview, WA 98632-2310
Phone (360) 414-2800

505 NE 87TH Ave
Vancouver, WA 98664-1965

8821 NE 5TH St
Vancouver, WA 98664-3200
Phone (360) 514-1900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60840702WAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Sep 4, 2018 Accepting new patients
Peacehealth CurrentSince Sep 4, 2018 Accepting new patients
Peacehealth Past Accepting new patients
Southcoast Physicians Group, Inc. Past Accepting new patients

Locations

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

625 9th Ave
Ste 120
Longview, WA 98632
Phone (360) 425-3720

1801 1st Ave
Ste 3A
Longview, WA 98632
Phone (360) 256-4425

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

14411 NE 20th Ave
Ste 101
Vancouver, WA 98686
Phone (360) 256-4425

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

Interoperability endpoints

  • Direct secure messaging: pobrien389232@direct.peacehealth.org

Organizations & group practices 4

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 8

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": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1326306317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 1ST AVE STE 3A",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323271",
            "telephone_number": "360-636-4469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "299 Faunce Corner Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "North Dartmouth",
            "state": "MA",
            "postal_code": "027471218",
            "country_code": "US",
            "telephone_number": "508-973-1550",
            "fax_number": "508-973-1355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "PRIYANKA",
        "middle_name": "SHAH",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "270776",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD60840702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.