NPIMap

Individual provider Active NPI

Prabhat Kumar Bhama, MD, MPH, FACS

  • Otolaryngology/Facial Plastic Surgery Physician
  • Everett, WA
National Provider Identifier
1962415430
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
MD61030796 Issued in WA
Practice address
1330 Rockefeller Ave Ste 310
Everett, WA 98201-1677
Phone
(425) 297-5359
NPI assigned
Aug 14, 2006
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X MD61030796 WA Primary
Otolaryngology Physician 207Y00000X MD61030796 WA

Addresses

Primary practice location

1330 Rockefeller Ave Ste 310
Everett, WA 98201-1677

Mailing address

1330 Rockefeller Ave Ste 310
Everett, WA 98201-1677
Phone (425) 297-5359

Other practice location 1

3216 Norton Ave Ste 202
Everett, WA 98201-4290
Phone (425) 297-5350

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pbhama1252697@wm.providencedirect.org Direct
Direct Messaging Address pbhama1252697@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140821000393 TX Practitioner - OtolaryngologyPractitioner - Surgical Oncology 6901024694 Reassigns benefits to 4 organizations
I20200618000808 WA Practitioner - Otolaryngology 6901024694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Michigan Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

16708 Bothell Everett Hwy
Suite 201
Mill Creek, WA 98012-6345
Phone (425) 482-9020

21601 76TH Ave W
Edmonds, WA 98026-7507
Phone (425) 640-4000

3801 University Lake Dr
Anchorage, AK 99508-4658
Phone (907) 563-2662

4112 Harbour Pointe Blvd SW
Suite 100
Mukilteo, WA 98275-5457
Phone (425) 347-6330

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision32
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61030796WAMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Jul 1, 2020 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Maniilaq Association CurrentSince Dec 18, 2014 Accepting new patients
Maniilaq Association CurrentSince Dec 18, 2014 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jul 28, 2014 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Aug 9, 2016 Accepting new patients
Providence Health & Services - Washington CurrentSince Jul 1, 2020 Accepting new patients
Tanana Chiefs Conference CurrentSince Jan 1, 2015 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Aug 9, 2016 Accepting new patients
Maniilaq Association Current Accepting new patients
Tanana Chiefs Conference CurrentSince Jan 1, 2015 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Bristol Bay Area Health Corporation Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

1330 Rockefeller Ave
Ste 310
Everett, WA 98201
Phone (425) 261-4925

3216 Norton Ave
Ste 202
Everett, WA 98201
Phone (425) 258-3181

16708 Bothell Hwy
Ste 201
Mill Creek, WA 98012
Phone (425) 316-9159

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

Interoperability endpoints

  • Direct secure messaging: pbhama1252697@wm.providencedirect.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1962415430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER AVE STE 310",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011677",
            "telephone_number": "425-297-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER AVE STE 310",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011677",
            "telephone_number": "425-297-5359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3216 Norton Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982014290",
            "country_code": "US",
            "telephone_number": "425-297-5350",
            "fax_number": "425-297-5355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHAMA",
        "first_name": "PRABHAT",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD, MPH, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "WA",
            "license": "MD61030796",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD61030796",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pbhama1252697@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3216 Norton Ave Ste 202",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982014290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pbhama1252697@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1330 Rockefeller Ave Ste 310",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.