Individual provider Active NPI

Peresi Kahirimbanyi Mugisha, M.D

  • Family Medicine Physician
  • Pasco, WA
National Provider Identifier
1790015766
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD 60193720 Issued in WA
Practice address
7425 Wrigley Dr Ste 100
Pasco, WA 99301-5292
Phone
(509) 416-8888
Fax
(509) 545-6842
NPI assigned
Jan 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD 60193720 WA Primary
Family Medicine Physician 207Q00000X 25754 OK

Addresses

Primary practice location

7425 Wrigley Dr Ste 100
Pasco, WA 99301-5292

Mailing address

7505 Sandifur Pkwy Ste 103
Pasco, WA 99301-8062
Phone (833) 411-5469

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
I20110926000110 WA Practitioner - Family Practice 7113198045 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25754OKMDFamily Medicine Physician
MD 60193720WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Hospital LLC Family Medicine CurrentSince Sep 1, 2018 Accepting new patients
Lourdes Hospital LLC Current Accepting new patients
Lourdes Hospital LLC Past Accepting new patients
Our Lady of Lourdes Health Center Family Medicine Past Accepting new patients

Locations

7425 Wrigley Dr
Ste 100
Pasco, WA 99301
Phone (509) 416-8888

7425 Wrigley Dr
Pasco, WA 99301
Phone (509) 416-8888

507 N 5th Ave
Pasco, WA 99301
Phone (509) 543-1975

520 N 4th Ave
Pasco, WA 99301
Phone (509) 544-6140

1200 N 14th Ave
Pasco, WA 99301
Phone (509) 547-7536

520 N 4th Ave
Ste 1000
Pasco, WA 99301

7425 Wrigley Dr
Ste 204
Pasco, WA 99301
Phone (509) 416-0027

7425 Wrigley Dr
Ste 1000
Pasco, WA 99301

1175 Carondelet Dr
Richland, WA 99354
Phone (509) 943-9104

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1790015766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 SANDIFUR PKWY STE 103",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018062",
            "telephone_number": "833-411-5469",
            "fax_number": "509-542-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7425 WRIGLEY DR STE 100",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015292",
            "telephone_number": "509-416-8888",
            "fax_number": "509-545-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGISHA",
        "first_name": "PERESI",
        "middle_name": "KAHIRIMBANYI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD 60193720",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "25754",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasco, WA

Sources for this page

Verify at the official NPI Registry.