Active NPI
Perry D Mostov, DO
- Family Medicine Physician
- Bainbridge Island, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OP60744283
- Practice address
- 1344 Wintergreen LN NE
Bainbridge Island, WA 98110 - Phone
- (206) 842-5632
- Fax
- (206) 842-5992
- NPI assigned
- Apr 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34004921 | OH | |
| Family Medicine Physician | 207Q00000X | OP60744283 | WA | Primary |
Addresses
Primary practice location
1344 Wintergreen LN NE
Bainbridge Island, WA 98110
Mailing address
1344 Wintergreen LN NE
Bainbridge Island, WA 98110-5118
Phone (206) 842-5632
Other practice location 1
6515 Pullman Dr
Suite 2200
Lewis Center, OH 43035-7380
Phone (614) 688-7150
Other practice location 2
380 Winslow Way E
Bainbridge Island, WA 98110-2424
Phone (206) 842-5631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0950734 | Medicaid | OH |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Ohio University, College of Osteopathic Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1344 Wintergreen LN NE
Bainbridge Island, WA 98110-5118
Phone (206) 842-5632
Hospital & facility affiliations
- CHI Franciscan Health at Home
- Virginia Mason Medical Center
- St Michael Medical Center
- Jefferson Healthcare
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34004921 | OH | MD | Family Medicine Physician |
| OP60744283 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia Mason Medical Center | Current | Accepting new patients | |
| Virginia Mason Medical Center | Current | Accepting new patients | |
| Osu Family Practice Services | Family Medicine | Current | Accepting new patients |
| Virginia Mason Medical Center | Current | Accepting new patients | |
| Virginia Mason Medical Center | Family Medicine | Current | Accepting new patients |
| Virginia Mason Medical Center | Past | Accepting new patients |
Locations
543 Taylor Ave
Fl 2
Columbus, OH 43203
Phone (614) 293-2700
2231 N High St
Columbus, OH 43201
Phone (614) 293-2700
6515 Pullman Dr
Ste 2200
Lewis Center, OH 43035
Phone (614) 688-7076
445 E Granville Rd
Worthington, OH 43085
Phone (614) 293-9450
380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632
1344 Wintergreen Ln NE
Bainbridge Island, WA 98110
Phone (206) 842-5632
380 Winslow Way E
#A
Bainbridge Island, WA 98110
925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860
4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000
1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/66ad9a50-d7f7-4c21-b933-2ba90047388e/
Organizations & group practices 6
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.
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1801851258
-
- Internal Medicine Physician
- Seattle, WA
- NPI 1194889071
-
- Family Medicine Physician
- Bainbridge Island, WA
- NPI 1730237942
-
- Interventional Cardiology Physician
- Tacoma, WA
- NPI 1821711953
-
- Family Medicine Physician
- Columbus, OH
- NPI 1659339653
-
- Gastroenterology Physician
- Seattle, WA
- NPI 1003970989
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- University Place, WA
- NPI 1972919249
-
- General Acute Care Hospital
- Silverdale, WA
- NPI 1518912609
-
- Medicare Defined Swing Bed Hospital Unit
- Port Townsend, WA
- NPI 1104950039
-
- Critical Access Hospital
- Port Townsend, WA
- NPI 1356492953
-
- Sleep Medicine (Psychiatry & Neurology) Physician
- Silverdale, WA
- NPI 1467664631
Hospital
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1801851258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529280000000",
"number": "1831152198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1344 WINTERGREEN LN NE",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "981105118",
"telephone_number": "206-842-5632",
"fax_number": "206-842-5992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1344 WINTERGREEN LN NE",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "98110",
"telephone_number": "206-842-5632",
"fax_number": "206-842-5992"
}
],
"practiceLocations": [
{
"address_1": "6515 Pullman Dr",
"address_2": "SUITE 2200",
"address_purpose": "LOCATION",
"city": "Lewis Center",
"state": "OH",
"postal_code": "430357380",
"country_code": "US",
"telephone_number": "614-688-7150",
"fax_number": "614-688-7155",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "380 Winslow Way E",
"address_purpose": "LOCATION",
"city": "Bainbridge Island",
"state": "WA",
"postal_code": "981102424",
"country_code": "US",
"telephone_number": "206-842-5631",
"fax_number": "206-842-5992",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOSTOV",
"first_name": "PERRY",
"middle_name": "D",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-08",
"last_updated": "2018-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34004921",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "OP60744283",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0950734",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bainbridge Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.