Individual provider Active NPI

Sami Imran Amjad, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Spokane, WA
National Provider Identifier
1760770788
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
MD60647799 Issued in WA
Practice address
104 W 5TH Ave
Spokane, WA 99204-4880
Phone
(509) 353-3960
NPI assigned
Jul 11, 2011
Last updated
Sep 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PG172233 OR
Student in an Organized Health Care Education/Training Program 390200000X MT199009 PA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X D92463 MD
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A167528 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 19500 NV
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 29420 WV
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD60647799 WA Primary

Addresses

Primary practice location

104 W 5TH Ave
Spokane, WA 99204-4880

Mailing address

2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone (732) 766-0683

Other practice location 1

800 Garfield Ave
Parkersburg, WV 26101-5340
Phone (304) 422-0405

Other practice location 2

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-7878

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address samjad154312@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address samjad154312@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211018000496 MD Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 1951520576 Reassigns benefits to 1 organization
I20231101002652 OH Practitioner - Critical Care (Intensivists) 1951520576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4000 Johnson Rd
Steubenville, OH 43952-2364
Phone (740) 264-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.23 of 100Reported as group
Quality
60.26
Promoting interoperability
100
Improvement activities
40
Cost
76.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A167528CAMDCritical Care Medicine (Internal Medicine) Physician
19500NVMDCritical Care Medicine (Internal Medicine) Physician
29420WVMDCritical Care Medicine (Internal Medicine) Physician
PG172233ORMDStudent in an Organized Health Care Education/Training Program
MT199009PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians, Inc CurrentSince Oct 18, 2021 Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Hospitalist Medicine Physicians of Ohio - Fairfield Professional Cor Critical Care Medicine CurrentSince Sep 18, 2023 Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Oct 18, 2021 Accepting new patients
Trinity Hospital Holding Company Past Accepting new patients
Lifebridge Community Physicians, Inc Critical Care Medicine Past Accepting new patients
West Virginia University Hospitals, Inc Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

4000 Johnson Rd
Wintersville, OH 43952
Phone (740) 264-8011

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Interoperability endpoints

  • Direct secure messaging: samjad155327@direct.renown.org

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 2

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": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1760770788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "732-766-0683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992044880",
            "telephone_number": "509-353-3960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Garfield Ave",
            "address_purpose": "LOCATION",
            "city": "Parkersburg",
            "state": "WV",
            "postal_code": "261015340",
            "country_code": "US",
            "telephone_number": "304-422-0405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1155 Mill St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021576",
            "country_code": "US",
            "telephone_number": "775-982-7878",
            "fax_number": "775-982-4196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMJAD",
        "first_name": "SAMI",
        "middle_name": "IMRAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-11",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "PG172233",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT199009",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MD",
            "license": "D92463",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A167528",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NV",
            "license": "19500",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WV",
            "license": "29420",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "MD60647799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samjad154312@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Garfield Ave",
            "city": "Parkersburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261015376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samjad154312@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Garfield Ave",
            "city": "Parkersburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261015376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.