Active NPI
Robert G Sperry, MD
- Family Medicine Physician
- Bellingham, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00033454
- Practice address
- 3130 Ellis St
Bellingham, WA 98225-1904 - Phone
- (360) 734-4404
- Fax
- (360) 734-7409
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD00033454 | WA | |
| Family Medicine Physician | 207Q00000X | MD00033454 | WA | Primary |
Addresses
Primary practice location
3130 Ellis St
Bellingham, WA 98225-1904
Mailing address
PO Box 5127
Everett, WA 98206-5127
Phone (360) 734-4404
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8229775 | Medicaid | WA |
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
- Family Practice
- Education
- University of Cincinnati College of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1330 Rockefeller Ave
Everett, WA 98201-1684
Phone (425) 259-0966
2901 174TH St NE
Marysville, WA 98271-4743
Phone (360) 454-1900
3130 Ellis St
Bellingham, WA 98225-1904
Phone (360) 734-4404
3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5442
4420 76TH St NE
Marysville, WA 98270-3726
Phone (360) 651-7490
7205 265TH St NW
Stanwood, WA 98292-6221
Phone (360) 629-1500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00033454 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Care Washington PLLC | Family Medicine | Current | Accepting new patients |
| The Polyclinic PLLC | Family Medicine | Current | Accepting new patients |
| The Polyclinic | Current | Accepting new patients | |
| Optum Care Washington PLLC | Family Medicine | Current | Accepting new patients |
| Mid-Ohio Emergency Services, LLC | Past | Accepting new patients |
Locations
3130 Ellis St
Bellingham, WA 98225
Phone (360) 734-4404
1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903
1145 Broadway
Seattle, WA 98122
9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777
904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487
1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299
1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900
Interoperability endpoints
- https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4
Organizations & group practices 6
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.
-
- Audiologist
- Seattle, WA
- NPI 1174594634
-
- Durable Medical Equipment & Medical Supplies
- Marysville, WA
- NPI 1194428425
Family Medicine
-
- Ambulatory Surgical Clinic/Center
- Seattle, WA
- NPI 1073944039
-
- Durable Medical Equipment & Medical Supplies
- Tacoma, WA
- NPI 1831411487
Family Medicine
-
- Emergency Medicine Physician
- Columbus, OH
- NPI 1386691780
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622592000000",
"number": "1417045550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5127",
"city": "EVERETT",
"state": "WA",
"postal_code": "982065127",
"telephone_number": "360-734-4404",
"fax_number": "360-734-7409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 ELLIS ST",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251904",
"telephone_number": "360-734-4404",
"fax_number": "360-734-7409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPERRY",
"first_name": "ROBERT",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2021-06-02",
"certification_date": "2021-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MD00033454",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00033454",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8229775",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.