Individual provider Active NPI

Omar Arif Jaffer, MD

  • Internal Medicine Physician
  • Bellingham, WA
National Provider Identifier
1700095494
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60448453 Issued in WA
Practice address
2980 Squalicum Pkwy
Suite 301
Bellingham, WA 98225-1880
Phone
(360) 788-6112
Fax
(360) 788-6114
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 38422 IA
Internal Medicine Physician 207R00000X 38422 IA
Pulmonary Disease Physician 207RP1001X 38422 IA
Internal Medicine Physician 207R00000X MD60448453 WA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD60448453 WA
Pulmonary Disease Physician 207RP1001X MD60448453 WA

Addresses

Primary practice location

2980 Squalicum Pkwy
Suite 301
Bellingham, WA 98225-1880

Mailing address

1115 SE 164TH Ave
Dept 358
Vancouver, WA 98683-9324
Phone (360) 788-6112

Other identifiers 2

IdentifierTypeStateIssuer
1700095494MedicaidIA
BP1-0026143OtherINSTITUTIONAL PERMIT

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
I20140818001374 WA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 4880877745 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
University of Texas Southwestern Medical School at Dallas, 2006
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

2980 Squalicum Pkwy
Bellingham, WA 98225-1880
Phone (360) 788-6112

3015 Squalicum Pkwy
Bellingham, WA 98225-1906

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60448453WAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Sep 1, 2014 Accepting new patients
Peacehealth Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
Peacehealth CurrentSince Jul 1, 2014 Accepting new patients
Peacehealth CurrentSince Sep 1, 2014 Accepting new patients
Peacehealth Medical Group - Sedro Woolley CurrentSince Sep 23, 2018 Accepting new patients

Locations

3100 Tongass Ave
Ketchikan, AK 99901
Phone (907) 225-4104

2980 Squalicum Pkwy
Ste 301
Bellingham, WA 98225
Phone (360) 671-4944

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

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

835 E Fairhaven Ave
Burlington, WA 98233
Phone (360) 755-0641

1117 Spring St
Friday Harbor, WA 98250
Phone (360) 378-1738

1990 Hospital Dr
Ste 100
Sedro Woolley, WA 98284
Phone (360) 856-4141

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

Interoperability endpoints

  • Direct secure messaging: ojaffer61695@direct.peacehealth.org

Organizations & group practices 5

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 5

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1700095494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE",
            "address_2": "DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839324",
            "telephone_number": "360-788-6112",
            "fax_number": "360-788-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 SQUALICUM PKWY",
            "address_2": "SUITE 301",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251880",
            "telephone_number": "360-788-6112",
            "fax_number": "360-788-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFER",
        "first_name": "OMAR",
        "middle_name": "ARIF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IA",
            "license": "38422",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "38422",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IA",
            "license": "38422",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60448453",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "MD60448453",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD60448453",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700095494",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0026143",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.