Individual provider Active NPI

Mohammad Mohiddin, M.D.

  • Internal Medicine Physician
  • Bellingham, WA
National Provider Identifier
1609225077
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60900601 Issued in WA
Practice address
4545 Cordata Pkwy Ste 2B
Bellingham, WA 98226
Phone
(360) 738-2200
Fax
(360) 752-5683
NPI assigned
Jun 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60900601 WA Primary

Addresses

Primary practice location

4545 Cordata Pkwy Ste 2B
Bellingham, WA 98226

Mailing address

1115 SE 164TH Ave Dept 358
Vancouver, WA 98683-8004
Phone (360) 729-1462

Other practice location 1

6071 W. Outer Drive
DMC-Sinai Grace Hospital
Detroit, MI 48235
Phone (313) 966-3300

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
I20190919000685 WA Practitioner - Internal Medicine 2567756521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 9537073960, 292 clinicians

Practice addresses (Care Compare)

2901 Sqaulicum Pkwy
Bellingham, WA 98225-1851
Phone (360) 788-9373

3001 Squalicum Pkwy
Suite 14a
Bellingham, WA 98225-1949
Phone (360) 788-6934

3015 Squalicum Pkwy
Bellingham, WA 98225-1906

Hospital & facility affiliations

  • Eden Home Health Home health agency, Bellingham, WA, CCN 507105
  • Signature Healthcare at Home Home health agency, Bellingham, WA, CCN 507116
  • Alpha Home Health Home health agency, Everett, WA, CCN 507107
  • Peacehealth Home Health of Whatcom County Home health agency, Bellingham, WA, CCN 507307
  • Peacehealth St Joseph Medical Center Hospital, Bellingham, WA, CCN 500030

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions116
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Sep 3, 2019 Accepting new patients
Peacehealth Internal Medicine CurrentSince Sep 3, 2019 Accepting new patients

Locations

4545 Cordata Pkwy
Ste 2B
Bellingham, WA 98226
Phone (360) 752-5220

3015 Squalicum Pkwy
Ste 200
Bellingham, WA 98225
Phone (360) 733-2092

3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

Interoperability endpoints

  • Direct secure messaging: mmohiddin420017@direct.peacehealth.org

Organizations & group practices 2

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 7

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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1609225077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838004",
            "telephone_number": "360-729-1462",
            "fax_number": "360-729-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY STE 2B",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98226",
            "telephone_number": "360-738-2200",
            "fax_number": "360-752-5683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6071 W. Outer Drive",
            "address_2": "DMC-Sinai Grace Hospital",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48235",
            "country_code": "US",
            "telephone_number": "313-966-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHIDDIN",
        "first_name": "MOHAMMAD",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60900601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.