Individual provider Active NPI

Dana R Mahmoud, DO

  • Psychiatry Physician
  • Seattle, WA
National Provider Identifier
1922373216
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OP60924399 Issued in WA
Practice address
747 Broadway
Seattle, WA 98122-4379
Phone
(206) 215-9853
Fax
(260) 215-3636
NPI assigned
Mar 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OP60924399 WA Primary

Addresses

Primary practice location

747 Broadway
Seattle, WA 98122-4379

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
1922373216MedicaidWA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190404000588 WA Practitioner - Psychiatry 5799079117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

1101 Madison St
Suite 310
Seattle, WA 98104-1320
Phone (206) 215-8100

747 Broadway
Seattle, WA 98122-4379
Phone (206) 386-6000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Current Accepting new patients
Swedish Health Services CurrentSince Mar 1, 2019 Accepting new patients
Swedish Health Services CurrentSince Mar 1, 2019 Accepting new patients
Swedish Health Services CurrentSince Mar 1, 2019 Accepting new patients

Locations

7320 216th St SW
Ste 200
Edmonds, WA 98026
Phone (425) 640-4000

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

800 5th Ave
Ste 600
Seattle, WA 98104

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1922373216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224379",
            "telephone_number": "206-215-9853",
            "fax_number": "260-215-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOUD",
        "first_name": "DANA",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "OP60924399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922373216",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.