Individual provider Active NPI

Haytham E Maria, M.D.

  • Surgery Physician
  • Seattle, WA
National Provider Identifier
1912254392
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD60880399 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-4330
Phone
(206) 520-5000
NPI assigned
Aug 5, 2012
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 14193088-1205 UT
Surgery Physician 208600000X MD60880399 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-4330

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

Other practice location 1

3592 W 9000 S Ste 210
West Jordan, UT 84088-8819
Phone (801) 208-1050

Other identifiers 1

IdentifierTypeStateIssuer
1912254392MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181031002167 TX Practitioner - General Surgery 1658668322 Reassigns benefits to 1 organization
I20200410000428 VT Practitioner - General Surgery 1658668322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Hospital CurrentSince Mar 19, 2020 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jul 20, 2020 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jul 20, 2020 Accepting new patients
Springfield Hospital Inc Surgery CurrentSince Mar 19, 2020 Accepting new patients
Springfield Hospital .Inc CurrentSince Mar 19, 2020 Accepting new patients

Locations

25 Ridgewood Rd
Springfield, VT 05156
Phone (780) 281-9593

29 Ridgewood Rd
Springfield, VT 05156
Phone (802) 885-5733

Interoperability endpoints

  • Direct secure messaging: haytham.maria@hca3.eclinicaldirectplus.com
  • Direct secure messaging: hmaria@yourcarecommunity.org

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, 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": "1344124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1912254392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981954330",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3592 W 9000 S Ste 210",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840888819",
            "country_code": "US",
            "telephone_number": "801-208-1050",
            "fax_number": "801-208-6376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARIA",
        "first_name": "HAYTHAM",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-05",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "14193088-1205",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60880399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912254392",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.