Samira Bahrainy, MD
Individual provider Active NPI Cardiovascular Disease Physician · Pueblo, CO
NPI 1447446901 · NPPES record last updated Mar 22, 2023
Key facts
- NPI
- 1447446901
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 11358501-1205 (UT)
- Practice address
- 311 W 14TH St
Pueblo, CO 81003-2705 - Phone
- (719) 584-4406
- NPI assigned
- Sep 19, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WA, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130926000169 | WA | Practitioner - Internal Medicine | 4688818909 | Reassigns benefits to 4 organizations |
| I20250116003376 | CA | Practitioner - Internal Medicine | 4688818909 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60087911 | WA | MD | Internal Medicine Physician |
| 11358501-1205 | UT | MD | Cardiovascular Disease Physician |
| DR.0063869 | CO | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospitalist Medicine Physicians of California - San Leandro, PC | Internal Medicine | Current |
Accepting new patients |
| Im-FSR Inc. | Hospitalist | Current |
Accepting new patients |
| Cogent Healthcare of Washington, PC | Internal Medicine | Current |
Accepting new patients |
| Hospitalist Group of Montebello Inc | Hospitalist | Current |
Accepting new patients |
| Legacy Salmon Creek Hospital | Current |
Accepting new patients | |
| South Sound Inpatient Physicians PLLC | Internal Medicine | Current |
Accepting new patients |
| Legacy Salmon Creek Hospital | Hospitalist | Current |
Accepting new patients |
| Northwest Hospital Medicine Physicians LLC | Internal Medicine | Current |
Accepting new patients |
Locations
800 S Main St
Corona, CA 92882
Phone (909) 625-5411
2701 S Bristol St
Santa Ana, CA 92704
Phone (714) 636-0342
1701 Santa Anita Ave
South El Monte, CA 91733
Phone (626) 350-7916
1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600
1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181
202 N Division St
Auburn, WA 98001
Phone (253) 333-2562
2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911
16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970
3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000
1415 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 416-5750
407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000
2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021
400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000
2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD60087911 | WA | |
| Hospitalist Physician | 208M00000X | MD60087911 | WA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | DR.0063869 | CO | |
| Cardiovascular Disease Physician | 207RC0000X | 11358501-1205 | UT | Yes |
Addresses
Primary practice location
311 W 14TH St
Pueblo, CO 81003-2705
Mailing address
311 W 14TH St
Pueblo, CO 81003-2705
Phone (719) 584-4406
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Pueblo |
Other providers in Pueblo, CO
- Thalia Dora Bachmann-Meyer
- Josephine Yolanda Pena Bacilio
- Back in Action, LLC
- David Russell Baer
- Saurabh Baghi
- Ben Adam Charles Bailey
- Beverly A. Bailey
- Chelsea Bailey
- Cydney Bailey
- Joelle Josephina Bailey
All providers in Pueblo, CO · Cardiovascular Disease Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.