Individual provider Active NPI

Bilal Ittiq, MD

  • Sports Medicine (Family Medicine) Physician
  • Bellingham, WA
National Provider Identifier
1467806224
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
MD61054337 Issued in WA
Practice address
3130 Squalicum Pkwy
Bellingham, WA 98225-1940
Phone
(360) 756-0382
NPI assigned
Apr 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X MD61054337 WA Primary

Addresses

Primary practice location

3130 Squalicum Pkwy
Bellingham, WA 98225-1940

Mailing address

3130 Squalicum Pkwy
Bellingham, WA 98225-1940
Phone (360) 756-0382

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20200812003844 WA Practitioner - Family PracticePractitioner - Sports Medicine 6608119490 Reassigns benefits to 2 organizations
I20220804001376 CA Practitioner - Sports Medicine 6608119490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Care Network, PLLCGroup PAC ID 0446142046, 124 clinicians

Practice addresses (Care Compare)

3130 Squalicum Pkwy
Suite 110
Bellingham, WA 98225-1940
Phone (360) 756-0382

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.36 of 100Reported as group
Quality
92.72
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61054337WAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lasermd Pain Relief, Inc. CurrentSince Sep 25, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 4, 2020 Accepting new patients
Family Care Network PLLC Current Accepting new patients
Lasermd Pain Relief, Inc. CurrentSince Sep 25, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 4, 2020 Accepting new patients
Family Care Network PLLC CurrentSince Jan 22, 2024 Accepting new patients
Family Care Network PLLC CurrentSince Jan 22, 2024 Accepting new patients

Locations

2809 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (213) 550-5600

578 Washington Blvd
Marina del Rey, CA 90292
Phone (323) 447-8372

1821 Wilshire Blvd
Ste 300
Santa Monica, CA 90403
Phone (213) 550-5600

3130 Squalicum Pkwy
Ste 110
Bellingham, WA 98225
Phone (360) 756-0382

3130 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 671-4509

1610 Grover St
Ste D1
Lynden, WA 98264
Phone (360) 312-3785

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

322 W North River Dr
Spokane, WA 99201
Phone (509) 241-2575

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: bittiq23099@direct.fcn.net

Organizations & group practices 8

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 1

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": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1467806224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 SQUALICUM PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251940",
            "telephone_number": "360-756-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 SQUALICUM PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251940",
            "telephone_number": "360-756-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITTIQ",
        "first_name": "BILAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD61054337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.