Individual provider Active NPI

Mikhail Pavlovich Nekhamis, CRNA

  • Certified Registered Nurse Anesthetist
  • Centralia, WA
National Provider Identifier
1750612917
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60139268 Issued in WA
Practice address
914 S Scheuber Rd
PMG SW Wa Centralia Anesthesiology
Centralia, WA 98531-9027
Phone
(360) 330-8501
Fax
(360) 330-8690
NPI assigned
Jan 27, 2010
Last updated
Mar 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP60139268 WA Primary

Addresses

Primary practice location

914 S Scheuber Rd
PMG SW Wa Centralia Anesthesiology
Centralia, WA 98531-9027

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (360) 486-6508

Other practice location 1

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 414-2000

Other identifiers 2

IdentifierTypeStateIssuer
RN00138262OtherWALICENSE
AP60139268OtherWALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110321000759 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931382413 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 5890689293, 188 clinicians
Columbia Anesthesia Group P SGroup PAC ID 8426954322, 71 clinicians

Practice addresses (Care Compare)

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

2211 NE 139TH St
Legacy Salmon Creek Hospital
Vancouver, WA 98686-2742
Phone (360) 487-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Olympia Multi Specialty Clinic CurrentSince Nov 2, 2015 Accepting new patients
Peacehealth CurrentSince May 6, 2024 Accepting new patients
Gastroenterology Associates Clinical Practice, PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 9, 2019 Accepting new patients
Columbia Anesthesia Group P S CurrentSince Jun 1, 2019 Accepting new patients
Tahoma Anesthesiology Consultants PS Past Accepting new patients

Locations

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

209 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8250

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

406 Black Hills Ln SW
Ste A
Olympia, WA 98502
Phone (360) 754-1727

500 Lilly Rd NE
Ste 204
Olympia, WA 98506
Phone (360) 413-8191

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

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

Interoperability endpoints

  • Direct secure messaging: mnekhamis428104@direct.peacehealth.org

Organizations & group practices 6

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 3

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": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1750612917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "360-486-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 S SCHEUBER RD",
            "address_2": "PMG SW WA CENTRALIA ANESTHESIOLOGY",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319027",
            "telephone_number": "360-330-8501",
            "fax_number": "360-330-8690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1615 Delaware St",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322367",
            "country_code": "US",
            "telephone_number": "360-414-2000",
            "fax_number": "360-414-7638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEKHAMIS",
        "first_name": "MIKHAIL",
        "middle_name": "PAVLOVICH",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-27",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60139268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN00138262",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP60139268",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.