NPIMap

Organization Active NPI

Peace Arch Cardiology, PC

  • Cardiovascular Disease Physician
  • Bellingham, WA
National Provider Identifier
1871754952
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD00044996 Issued in WA
Legal business name
PEACE ARCH CARDIOLOGY, PC
Practice address
1215 Old Fairhaven Pkwy
Suite B
Bellingham, WA 98225-7444
Phone
(360) 594-4002
Fax
(360) 594-4006
NPI assigned
Jun 20, 2008
Last updated
Jun 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Mr. Rajesh Bhola, MDNPI 1356365001
Title
President
Phone
(360) 594-4002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X MD00044996 WA Primary

Addresses

Primary practice location

1215 Old Fairhaven Pkwy
Suite B
Bellingham, WA 98225-7444

Mailing address

1215 Old Fairhaven Pkwy
Suite B
Bellingham, WA 98225-7444
Phone (360) 594-4002

Other identifiers 2

IdentifierTypeStateIssuer
807261100MedicaidID
1356365001OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080717000179 WA Part B Supplier - Clinic/Group Practice 1951474402 Receives reassigned benefits from 7 practitioners
Practice locations: Bellingham, WA

National Provider Directory

National Provider Directory

Locations

1215 Old Fairhaven Pkwy
Ste B
Bellingham, WA 98225
Phone (360) 594-4002

1344 King St
Bellingham, WA 98229

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1871754952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 OLD FAIRHAVEN PKWY",
            "address_2": "SUITE B",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257444",
            "telephone_number": "360-594-4002",
            "fax_number": "360-594-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 OLD FAIRHAVEN PKWY",
            "address_2": "SUITE B",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257444",
            "telephone_number": "360-594-4002",
            "fax_number": "360-594-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE ARCH CARDIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "BHOLA",
        "authorized_official_first_name": "RAJESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-594-4002",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00044996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807261100",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1356365001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.