NPIMap

Individual provider Active NPI

Majd Isreb, M.D.

  • Nephrology Physician
  • Longview, WA
National Provider Identifier
1669426243
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD00048412 Issued in WA
Practice address
1615 Delaware St
Longview, WA 98632-2310
Phone
(360) 414-2727
NPI assigned
May 19, 2006
Last updated
Nov 14, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 2003-0641 NM
Nephrology Physician 207RN0300X MD00048412 WA Primary

Addresses

Primary practice location

1615 Delaware St
Longview, WA 98632-2310

Mailing address

6004 Tee CT
Farmington, NM 87402-4925
Phone (505) 327-1157

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
I20071005000167 WA Practitioner - NephrologyPractitioner - Internal Medicine 0749273290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 5890689293, 188 clinicians

Practice addresses (Care Compare)

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 636-4814

1660 Delware St
Longview, WA 98632-2310
Phone (360) 414-2800

600 Broadway St
Longview, WA 98632-3256
Phone (360) 414-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003-0641NMMDNephrology Physician
MD00048412WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Dec 1, 2014 Accepting new patients
Peacehealth Nephrology CurrentSince Dec 26, 2007 Accepting new patients
San Juan Nephrology Nephrology Past Accepting new patients
Peacehealth Past Accepting new patients

Locations

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

Interoperability endpoints

  • Direct secure messaging: misreb2649@direct.peacehealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1669426243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6004 TEE CT",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874024925",
            "telephone_number": "505-327-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 DELAWARE ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322310",
            "telephone_number": "360-414-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISREB",
        "first_name": "MAJD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NM",
            "license": "2003-0641",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD00048412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.