Individual provider Active NPI

Eric D Ferraris, MD

  • Emergency Medicine Physician
  • Vancouver, WA
National Provider Identifier
1710278023
Registry record updated Jul 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0107187BA Issued in IN
Practice address
600 NE 92ND Ave
Emergency Department
Vancouver, WA 98664-3225
Phone
(360) 514-2142
Fax
(360) 514-6820
NPI assigned
Apr 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 0107187BA IN Primary

Addresses

Primary practice location

600 NE 92ND Ave
Emergency Department
Vancouver, WA 98664-3225

Mailing address

600 NE 92ND Ave
Emergency Department
Vancouver, WA 98664-3225
Phone (360) 514-2142

Other identifiers 1

IdentifierTypeStateIssuer
201102180MedicaidIN

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
I20140923000015 WA Practitioner - Emergency Medicine 6608015011 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0107187BAINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Jul 14, 2014 Accepting new patients
Emergency Medicine Associates PC Emergency Medicine CurrentSince Jul 14, 2014 Accepting new patients

Locations

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

600 NE 92nd Ave
Vancouver, WA 98664
Phone (360) 514-2142

Interoperability endpoints

  • Direct secure messaging: eferraris74627@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": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404604800000",
    "number": "1710278023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NE 92ND AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643225",
            "telephone_number": "360-514-2142",
            "fax_number": "360-514-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NE 92ND AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643225",
            "telephone_number": "360-514-2142",
            "fax_number": "360-514-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRARIS",
        "first_name": "ERIC",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-21",
        "last_updated": "2014-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "0107187BA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201102180",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.