NPIMap

Individual provider Active NPI

Ivan Pe Law, MD

  • Hematology & Oncology Physician
  • Ilwaco, WA
National Provider Identifier
1720260441
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD00031977 Issued in WA
Practice address
176 1St Ave N
Ilwaco, WA 98624-9137
Phone
(360) 642-3747
Fax
(360) 642-3361
NPI assigned
Dec 4, 2007
Last updated
Jun 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MD00031977 WA Primary

Addresses

Primary practice location

176 1St Ave N
Ilwaco, WA 98624-9137

Mailing address

PO Box N
Ilwaco, WA 98624-0319
Phone (360) 642-3747

Other practice location 1

931 Highland Blvd Ste 3130
Bozeman, MT 59715-6914
Phone (406) 414-5150

Other identifiers 2

IdentifierTypeStateIssuer
041160MedicaidOR
1233709MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ilaw17282172@direct.sanfordhealth.org Direct Bozeman Health Deaconess Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20200303002133 AZ Practitioner - Hematology/Oncology 0446213037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1964
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HRMC, LLCGroup PAC ID 3072641265, 33 clinicians

Practice addresses (Care Compare)

101 Civic Ctr LN
Lake Havasu City, AZ 86403-5607
Phone (928) 453-3761

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00031977WAMDHematology & Oncology Physician
10631ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
HRMC, LLC Hematology & Oncology CurrentSince Jan 11, 2020 Accepting new patients
HRMC, LLC CurrentSince Jan 11, 2020 Accepting new patients
Bozeman Health Deaconess Hospital Past Accepting new patients
Monument Physiatry, PC Past Accepting new patients
HRMC, LLC Past Accepting new patients
Bozeman Health Deaconess Hospital Past Accepting new patients
Ivan P Law MD PC Hematology & Oncology PastSince Jan 1, 1978 Accepting new patients

Locations

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19231/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ilaw17282172@direct.sanfordhealth.org
  • Direct secure messaging: ivan.law@cancercarewesternarizona.ikm.direct-ci.com

Organizations & group practices 7

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 4

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": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1720260441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX N",
            "city": "ILWACO",
            "state": "WA",
            "postal_code": "986240319",
            "telephone_number": "360-642-3747",
            "fax_number": "360-642-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 1ST AVE N",
            "city": "ILWACO",
            "state": "WA",
            "postal_code": "986249137",
            "telephone_number": "360-642-3747",
            "fax_number": "360-642-3361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "931 Highland Blvd Ste 3130",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597156914",
            "country_code": "US",
            "telephone_number": "406-414-5150",
            "fax_number": "406-414-5029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAW",
        "first_name": "IVAN",
        "middle_name": "PE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WA",
            "license": "MD00031977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041160",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1233709",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ilaw17282172@direct.sanfordhealth.org",
            "affiliation": "Y",
            "affiliationName": "Bozeman Health Deaconess Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "931 Highland Blvd Ste 3130",
            "city": "Bozeman",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597156914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ilwaco, WA

Sources for this page

Verify at the official NPI Registry.