NPIMap

Individual provider Active NPI

Sanjeev Vaderah, MD

  • Interventional Cardiology Physician
  • Mount Vernon, WA
National Provider Identifier
1790738532
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD00035551 Issued in WA
Practice address
307 S. 13TH St., Suite 300
Skagit Regional Clinics-Cardiology
Mount Vernon, WA 98274
Phone
(360) 336-9757
Fax
(360) 336-2088
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD00035551 WA
Cardiovascular Disease Physician 207RC0000X M9435 ID
Interventional Cardiology Physician 207RI0011X MD00035551 WA Primary

Addresses

Primary practice location

307 S. 13TH St., Suite 300
Skagit Regional Clinics-Cardiology
Mount Vernon, WA 98274

Mailing address

1400 E. Kincaid St.
Attn: Credentialing
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

Other identifiers 2

IdentifierTypeStateIssuer
0231330OtherWAL&I
8294514MedicaidWA

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
I20040414000648 WA Practitioner - Peripheral Vascular DiseasePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 3375537046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Peripheral Vascular DiseaseAlso: Interventional Cardiology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

307 S 13TH St
Suite 300
Mount Vernon, WA 98274-4100
Phone (360) 336-9757

Hospital & facility affiliations

  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003
  • Cascade Valley Hospital Hospital, Arlington, WA, CCN 500060
  • Island Hospital Hospital, Anacortes, WA, CCN 500007
  • Whidbeyhealth Medical Center Hospital, Coupeville, WA, CCN 501339

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting33
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9435IDMDCardiovascular Disease Physician
MD00035551WAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Nov 1, 2010 Accepting new patients
Providence Health & Services-Wa Past Accepting new patients
Inland Cardiology Associates, P.S. Cardiovascular Disease PastSince Aug 25, 2014 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

2511 M Ave
Ste D
Anacortes, WA 98221
Phone (360) 293-0308

328 S Stillaguamish Ave
Arlington, WA 98223
Phone (360) 435-2133

1415 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 416-5750

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

307 S 13th St
Ste 300
Mount Vernon, WA 98274
Phone (360) 336-9757

Interoperability endpoints

  • Direct secure messaging: svaderah15427@skagit.direct-ci.com

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 9

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1790738532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E. KINCAID ST.",
            "address_2": "ATTN: CREDENTIALING",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2500",
            "fax_number": "360-428-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S. 13TH ST., SUITE 300",
            "address_2": "SKAGIT REGIONAL CLINICS-CARDIOLOGY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "98274",
            "telephone_number": "360-336-9757",
            "fax_number": "360-336-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADERAH",
        "first_name": "SANJEEV",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00035551",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M9435",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD00035551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0231330",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8294514",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.