Individual provider Active NPI

Robert G Sperry, MD

  • Family Medicine Physician
  • Bellingham, WA
National Provider Identifier
1417045550
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00033454 Issued in WA
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

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
8229775MedicaidWA

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
I20100721000769 WA Practitioner - Family Practice 9032241369 Reassigns benefits to 2 organizations

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
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00033454WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC Family Medicine CurrentSince Jun 1, 2021 Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince Dec 23, 2025 Accepting new patients
The Polyclinic CurrentSince Dec 23, 2025 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Jun 1, 2021 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

  • FHIR API: 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.

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

Verify at the official NPI Registry.