Individual provider Active NPI

Sam Naficy, M.D., P.S.

  • Specialist
  • Bellevue, WA
National Provider Identifier
1801816947
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD00037251 Issued in WA
Practice address
1110 112TH Ave NE Ste 150
Bellevue, WA 98004-4570
Phone
(425) 450-0880
Fax
(425) 450-0883
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD00037251 WA Primary

Addresses

Primary practice location

1110 112TH Ave NE Ste 150
Bellevue, WA 98004-4570

Mailing address

1110 112TH Ave NE Ste 150
Bellevue, WA 98004-4570
Phone (425) 450-0880

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
I20040415001345 WA Practitioner - Otolaryngology 7618879180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Washington School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sam Naficy MD PS IncGroup PAC ID 3072506849, 2 clinicians

Practice addresses (Care Compare)

1110 112TH Ave NE
Suite 150
Bellevue, WA 98004-4570
Phone (425) 450-0880

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sam Naficy, MD, PS, Inc CurrentSince Apr 7, 2004 Accepting new patients
Tidal Anesthesia, PLLC Past Accepting new patients
Strother Dermatology and Laser Treatment Center PLLC PastSince Oct 10, 2018 Accepting new patients

Locations

1110 112th Ave NE
Ste 150
Bellevue, WA 98004
Phone (425) 450-0880

218 Main St
Kirkland, WA 98033
Phone (425) 681-2300

12911 120th Ave NE
Ste G100
Kirkland, WA 98034
Phone (425) 899-4144

Organizations & group practices 3

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1801816947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 112TH AVE NE STE 150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044570",
            "telephone_number": "425-450-0880",
            "fax_number": "425-450-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 112TH AVE NE STE 150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044570",
            "telephone_number": "425-450-0880",
            "fax_number": "425-450-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAFICY",
        "first_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "M.D., P.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00037251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.