NPIMap

Individual provider Active NPI

Gopal Ghimire, MD, PHD, MRCP

  • Interventional Cardiology Physician
  • Olympia, WA
National Provider Identifier
1811225923
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD60562967 Issued in WA
Practice address
500 Lilly Rd NE Ste 100
Providence Cardiology Associates
Olympia, WA 98506-5195
Phone
(360) 413-8525
NPI assigned
Dec 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X MD60562967 WA Primary

Addresses

Primary practice location

500 Lilly Rd NE Ste 100
Providence Cardiology Associates
Olympia, WA 98506-5195

Mailing address

500 Lilly Rd NE Ste 100
Providence Cardiology Associates
Olympia, WA 98506-5195
Phone (360) 413-8525

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gghimire535337@wm.providencedirect.org 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
I20150630003172 WA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7719124577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 493-4083

500 Lilly Rd NE
Suite 100
Olympia, WA 98506-5195
Phone (360) 413-8525

525 Lilly Rd NE
Olympia, WA 98506-5101

914 S Scheuber Rd
Centralia, WA 98531-9027
Phone (360) 736-2803

Hospital & facility affiliations

  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
  • Mason General Hospital & Family of Clinics Hospital, Shelton, WA, CCN 501336

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting181
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Jun 1, 2017 Accepting new patients
Providence Health & Services Washington CurrentSince Aug 1, 2015 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Providence Health & Services Washington CurrentSince Aug 1, 2015 Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

410 Providence Ln NE
Bldg 2
Olympia, WA 98506
Phone (360) 493-4500

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

1018 Capitol Way S
Ste 300
Olympia, WA 98501
Phone (360) 486-6508

500 Lilly Rd NE
Ste 100
Olympia, WA 98506
Phone (360) 413-8525

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

939 Mountain View Dr
Ste 120
Shelton, WA 98584
Phone (360) 427-2733

Organizations & group practices 5

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 8

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": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1811225923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LILLY RD NE STE 100",
            "address_2": "PROVIDENCE CARDIOLOGY ASSOCIATES",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065195",
            "telephone_number": "360-413-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LILLY RD NE STE 100",
            "address_2": "PROVIDENCE CARDIOLOGY ASSOCIATES",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065195",
            "telephone_number": "360-413-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHIMIRE",
        "first_name": "GOPAL",
        "name_prefix": "Dr.",
        "credential": "MD, PHD, MRCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-01",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD60562967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gghimire535337@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 Lilly Rd NE Ste 100",
            "address_2": "Providence Cardiology Associates",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.