Ajainder Shergill, D.O., M.B.A

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

OP60097497 Issued in WA

Practice address

2603 Bridgeport Way W Ste F
University Place, WA 98466-4724

Phone

(253) 666-6780

Fax

(253) 666-6793

NPI assigned

Jun 26, 2007

Last updated

Nov 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, NV, FL3 enrollments

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 3

Specialty

Internal Medicine

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2006

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Medtriq LLCGroup PAC ID 9133348766, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Business Administration, Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medtriq LLC

  • Primary Care Clinic/Center
  • University Place, WA
  • NPI 1841605524
  Medicare reassignment Care Compare group NPD Authorized official
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Curasive LLC

  • Addiction (Substance Use Disorder) Counselor
  • Reno, NV
  • NPI 1104479971

  Internal Medicine

  Medicare reassignment NPD
• Clear Mental Health LLC

  • Psychiatry Physician
  • University Place, WA
  • NPI 1851926992
  Authorized official Same address or phone
• Medtriq Treatment Center LLC

  • Clinic/Center
  • University Place, WA
  • NPI 1215446729
  Authorized official Same address or phone
• Rezolv Health Medical Group Inc

  • Internal Medicine Physician
  • St Petersburg, FL
  • NPI 1689396087
  Authorized official Same address or phone
• Kaiser Foundation Health Plan of Washington

  dba Everett Medical Center

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1669619870
  NPD

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1366648222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 CROW CANYON RD STE S360",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945061189",
            "telephone_number": "360-334-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 BRIDGEPORT WAY W STE F",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664724",
            "telephone_number": "253-666-6780",
            "fax_number": "253-666-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERGILL",
        "first_name": "AJAINDER",
        "name_prefix": "Dr.",
        "credential": "D.O., M.B.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP60097497",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "WA",
            "license": "OP60097497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Grace Shaw, LMHC, CPT, CWS
• Robin Deanne Sheller
• Shelley Kelly Psychiatric Services LLC
• Glenda McGowen Shepard, ARNP
• Janice Shepard
• Shifa Healthcare PLLC
• Tatiana Shiyan, LMT
• Kelcie Shorter
• Jeffrey Keith Silverberg, MPT
• Sofe Silverman, LMP

• Addiction Medicine (Internal Medicine) Physician in University Place, WA
• Providers in University Place, WA by specialty
• Addiction Medicine (Internal Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.