Individual provider Active NPI

Grace Bhak, MD

  • Obstetrics & Gynecology Physician
  • Everett, WA
National Provider Identifier
1902164874
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD60970294 Issued in WA
Practice address
900 Pacific Ave
Everett, WA 98201-4168
Phone
(425) 339-5430
NPI assigned
Apr 30, 2012
Last updated
Sep 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT201361 PA
Obstetrics & Gynecology Physician 207V00000X A140322 CA
Obstetrics & Gynecology Physician 207V00000X MT201361 PA
Obstetrics & Gynecology Physician 207V00000X MD60970294 WA Primary

Addresses

Primary practice location

900 Pacific Ave
Everett, WA 98201-4168

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 949-6044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160920002995 CA Practitioner - Obstetrics/Gynecology 2860789765 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A140322CAMDObstetrics & Gynecology Physician
MD60970294WAMDObstetrics & Gynecology Physician
MT201361PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Mar 2, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

Interoperability endpoints

  • Direct secure messaging: gbhak17912@direct.tecmc.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1902164874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-949-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PACIFIC AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014168",
            "telephone_number": "425-339-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAK",
        "first_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT201361",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A140322",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MT201361",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD60970294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.