Individual provider Active NPI

Charles Anthony Gargano, M.D.

  • Internal Medicine Physician
  • Bellingham, WA
National Provider Identifier
1689663288
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00042376 Issued in WA
Practice address
4545 Cordata Pkwy
Bellingham, WA 98226-7123
Phone
(360) 738-2200
Fax
(360) 752-5682
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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 MD00042376 WA Primary

Addresses

Primary practice location

4545 Cordata Pkwy
Bellingham, WA 98226-7123

Mailing address

PO Box 5096
Bellingham, WA 98227-5096
Phone (360) 738-2200

Other identifiers 5

IdentifierTypeStateIssuer
1689663288MedicaidWA
4446GAOtherWAREGENCE
8361537MedicaidWA
0229843OtherWAL&I AND CRIME VICTIMS
7830444OtherWAAETNA

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
I20080402000396 WA Practitioner - Internal Medicine 4284711169 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00042376WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Internal Medicine CurrentSince Jan 1, 2008 Accepting new patients
Peacehealth Past Accepting new patients

Locations

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

2901 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 734-5400

4545 Cordata Pkwy
Ste 1A
Bellingham, WA 98226
Phone (360) 733-7687

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

4545 Cordata Pkwy
Bellingham, WA 98226
Phone (360) 752-5646

Interoperability endpoints

  • Direct secure messaging: agargano10219@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.

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1689663288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5096",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982275096",
            "telephone_number": "360-738-2200",
            "fax_number": "360-752-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267123",
            "telephone_number": "360-738-2200",
            "fax_number": "360-752-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARGANO",
        "first_name": "CHARLES",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00042376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689663288",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "4446GA",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8361537",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I AND CRIME VICTIMS",
            "identifier": "0229843",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7830444",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.