NPIMap

Individual provider Active NPI

Kamyar Vaziri, M.D.

  • Internal Medicine Physician
  • Bonney Lake, WA
National Provider Identifier
1760844708
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60886183 Issued in WA
Practice address
9230 Sky Island Dr E FL 2
Bonney Lake, WA 98391-7385
Phone
(253) 750-6110
NPI assigned
Mar 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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
Internal Medicine Physician 207R00000X MD60886183 WA Primary

Addresses

Primary practice location

9230 Sky Island Dr E FL 2
Bonney Lake, WA 98391-7385

Mailing address

9230 Sky Island Dr E Ste 101
Bonney Lake, WA 98391-7385
Phone (253) 750-6110

Other identifiers 1

IdentifierTypeStateIssuer
2076944MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kvaziri514027@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20191106000113 WA Practitioner - Internal Medicine 3375875610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

9230 Sky Island Dr E
FL 1
Bonney Lake, WA 98391-7385
Phone (253) 750-6022

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Tacoma, WA, CCN 507031
  • Signature Healthcare at Home Home health agency, Federal Way, WA, CCN 507110
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141
  • St Elizabeth Hospital Hospital, Enumclaw, WA, CCN 501335
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Internal Medicine CurrentSince Sep 16, 2019 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group PastSince Sep 16, 2019 Accepting new patients

Locations

9230 Sky Island Dr E
Fl 2
Bonney Lake, WA 98391
Phone (253) 426-4352

9230 Sky Island Dr E
Ste 101
Bonney Lake, WA 98391

9230 Sky Island Dr E
Bonney Lake, WA 98391
Phone (253) 750-6000

9230 Sky Island Dr E
Fl 1
Bonney Lake, WA 98391
Phone (253) 750-6000

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: kvaziri514027@fhsce.catholichealth.net

Organizations & group practices 4

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 11

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1760844708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9230 SKY ISLAND DR E STE 101",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917385",
            "telephone_number": "253-750-6110",
            "fax_number": "253-922-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9230 SKY ISLAND DR E FL 2",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917385",
            "telephone_number": "253-750-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZIRI",
        "first_name": "KAMYAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60886183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2076944",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kvaziri514027@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9230 Sky Island Dr E Fl 2",
            "city": "Bonney Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983917385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

Verify at the official NPI Registry.