Individual provider Active NPI

James Brad Diestelhorst, M.D.

  • Pulmonary Disease Physician
  • Bellingham, WA
National Provider Identifier
1336148766
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD00041071 Issued in WA
Practice address
4545 Cordata Pkwy
Bellingham, WA 98226-7123
Phone
(360) 738-2200
Fax
(360) 752-5687
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD00041071 WA Primary

Addresses

Primary practice location

4545 Cordata Pkwy
Bellingham, WA 98226-7123

Mailing address

PO Box 5096
Bellingham, WA 98227-5096
Phone (360) 738-2200

Other identifiers 6

IdentifierTypeStateIssuer
4912DIOtherWAREGENCE
7704353OtherWAAETNA
1336148766MedicaidWA
0230369OtherWAL&I/CRIME VICTIMS
MD4918WOtherAKALASKA MEDICAID
0230369OtherWAL&I AND 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050425000543 WA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 0547208092 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 9537073960, 292 clinicians

Practice addresses (Care Compare)

2901 Sqaulicum Pkwy
Bellingham, WA 98225-1851
Phone (360) 788-9373

2980 Squalicum Pkwy
Bellingham, WA 98225-1880
Phone (360) 788-6112

3001 Squalicum Pkwy
Suite 14a
Bellingham, WA 98225-1949
Phone (360) 788-6934

3015 Squalicum Pkwy
Bellingham, WA 98225-1906

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Medical Group - Sedro Woolley CurrentSince Sep 1, 2019 Accepting new patients
Peacehealth CurrentSince Jun 1, 2008 Accepting new patients
Peacehealth Past Accepting new patients

Locations

2980 Squalicum Pkwy
Ste 301
Bellingham, WA 98225
Phone (360) 671-4944

2901 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 734-5400

4545 Cordata Pkwy
Ste 1A
Bellingham, WA 98226
Phone (360) 733-7687

3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186

4545 Cordata Pkwy
Bellingham, WA 98226
Phone (360) 752-5646

835 E Fairhaven Ave
Burlington, WA 98233
Phone (360) 755-0641

1990 Hospital Dr
Ste 100
Sedro Woolley, WA 98284
Phone (360) 856-4141

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

Interoperability endpoints

  • Direct secure messaging: jdiestelhorst4238@direct.peacehealth.org

Organizations & group practices 3

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 4

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1336148766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5096",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982275096",
            "telephone_number": "360-738-2200",
            "fax_number": "360-752-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267123",
            "telephone_number": "360-738-2200",
            "fax_number": "360-752-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIESTELHORST",
        "first_name": "JAMES",
        "middle_name": "BRAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD00041071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "4912DI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7704353",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336148766",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I/CRIME VICTIMS",
            "identifier": "0230369",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALASKA MEDICAID",
            "identifier": "MD4918W",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I AND CRIME VICTIMS",
            "identifier": "0230369",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.