NPIMap

Individual provider Active NPI

Hisam Said Goueli, M.D.

  • Psychiatry Physician
  • Seattle, WA
National Provider Identifier
1639382906
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD60302051 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98109
Phone
(216) 844-3944
NPI assigned
May 7, 2007
Last updated
Dec 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60302051 WA
Psychiatry Physician 2084P0800X MD60302051 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98109

Mailing address

PO Box 50095
Seattle, WA 98145
Phone (206) 543-6420

Other identifiers 1

IdentifierTypeStateIssuer
1639382906MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121030000555 WA Practitioner - Psychiatry 3870644776 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Sammamish, WA 98075

Seattle, WA 98122

5300 Tallman Ave NW
4 North
Seattle, WA 98107-3932

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60302051WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Mar 14, 2022 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services- Washington CurrentSince Jan 1, 2021 Accepting new patients
Providence Health & Services Washington CurrentSince Dec 10, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 15, 2022 Accepting new patients
Providence Health & Services Washington Family Medicine CurrentSince Dec 10, 2020 Accepting new patients
Providence Health & Services Washington Family Medicine CurrentSince Sep 1, 2021 Accepting new patients
Providence Health & Services Mt Family Medicine CurrentSince Sep 15, 2021 Accepting new patients
Providence Medical Institute Family Medicine CurrentSince Nov 8, 2021 Accepting new patients
Providence Health & Services - Washington CurrentSince Jan 1, 2021 Accepting new patients
Providence Health & Services Oregon Psychiatry CurrentSince Apr 15, 2022 Accepting new patients
Providence Medical Institute Family Medicine CurrentSince Nov 8, 2021 Accepting new patients
Providence Health & Services - Washington Family Medicine CurrentSince Jan 1, 2021 Accepting new patients

Locations

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

5300 Tallman Ave NW
#4
Seattle, WA 98107
Phone (206) 297-5100

380 Chase Ave
Walla Walla, WA 99362
Phone (509) 526-3333

Interoperability endpoints

  • Direct secure messaging: hgoueli1191956@wm.providencedirect.org

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1639382906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98145",
            "telephone_number": "206-543-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98109",
            "telephone_number": "216-844-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUELI",
        "first_name": "HISAM",
        "middle_name": "SAID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60302051",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60302051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639382906",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.