Individual provider Active NPI

Robert Stanislaw Niznik, MD

  • Nephrology Physician
  • Bellingham, WA
National Provider Identifier
1922447069
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD60890396 Issued in WA
Practice address
3104 Squalicum Pkwy Ste 101
Bellingham, WA 98225-1941
Phone
(360) 734-9233
Fax
(360) 738-8974
NPI assigned
Jun 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 60296 MN
Student in an Organized Health Care Education/Training Program 390200000X TL.0004905 CO
Nephrology Physician 207RN0300X MD60890396 WA Primary

Addresses

Primary practice location

3104 Squalicum Pkwy Ste 101
Bellingham, WA 98225-1941

Mailing address

3104 Squalicum Pkwy Ste 101
Bellingham, WA 98225-1941
Phone (360) 734-9233

Other practice location 1

Mayo Clinic 200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 2

Mayo Clinic 200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other identifiers 1

IdentifierTypeStateIssuer
2063556MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address renaes@direct.care360.com Direct

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
I20190710002372 WA Practitioner - Nephrology 4284851247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mt. Baker Nephrology Associates Inc PSGroup PAC ID 7113814971, 4 clinicians
Snokidney PLLCGroup PAC ID 7911349295, 11 clinicians

Practice addresses (Care Compare)

Bellingham, WA 98225
Phone (360) 734-9233

2707 Colby Ave
Suite 718
Everett, WA 98201-3564
Phone (425) 339-5413

Hospital & facility affiliations

  • DaVita Mount Baker Kidney at Home Dialysis facility, Bellingham, WA, CCN 502501
  • DaVita Ferndale Dialysis Dialysis facility, Ferndale, WA, CCN 502619
  • Peacehealth St Joseph Medical Center Hospital, Bellingham, WA, CCN 500030

Merit-based Incentive Payment System (MIPS)

Final score
61.51 of 100Reported as individual
Quality
77.68
Improvement activities
0
Cost
79.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60890396WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mt. Baker Nephrology Associates Inc PS CurrentSince Jul 29, 2019 Accepting new patients
Snokidney PLLC Nephrology CurrentSince Oct 1, 2025 Accepting new patients
Washington Kidney Care LLC Nephrology PastSince Aug 4, 2024 Accepting new patients

Locations

410 Birchwood Ave
Ste 200
Bellingham, WA 98225
Phone (360) 554-2501

3104 Squalicum Pkwy
Ste 101
Bellingham, WA 98225
Phone (360) 733-2557

2707 Colby Ave
Ste 718
Everett, WA 98201
Phone (425) 339-5413

Interoperability endpoints

  • Direct secure messaging: robert.niznik@direct.davitaphysiciansolutions.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1922447069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 SQUALICUM PKWY STE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251941",
            "telephone_number": "360-734-9233",
            "fax_number": "360-738-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 SQUALICUM PKWY STE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251941",
            "telephone_number": "360-734-9233",
            "fax_number": "360-738-8974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Mayo Clinic 200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Mayo Clinic 200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIZNIK",
        "first_name": "ROBERT",
        "middle_name": "STANISLAW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-21",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "60296",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL.0004905",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD60890396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2063556",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "renaes@direct.care360.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "410 Birchwood Ave Ste 200",
            "city": "Bellingham",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982251783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.