Anand Selvam, M.D.
Individual provider Active NPI Emergency Medicine Physician · Forks, WA
NPI 1962769760 · NPPES record last updated Jan 21, 2021
Key facts
- NPI
- 1962769760
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- MD60824986 (WA)
- Practice address
- 530 Bogachiel Way
Forks, WA 98331 - Phone
- (360) 374-6271
- NPI assigned
- Apr 18, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Boston University School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Puget Sound Physicians PLLC
Practice addresses (Care Compare)
1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5000
Hospital & facility affiliations
- Overlake Hospital Medical Center & Clinics
- Snoqualmie Valley Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180524002813 | WA | Practitioner - Emergency Medicine | 5496994956 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 127708 | AK | MD | Emergency Medicine Physician |
| 125630 | OH | MD | Emergency Medicine Physician |
| 57.02092 | OH | MD | Emergency Medicine Physician |
| MD60824986 | WA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dispatchhealth Washington PC | Emergency Medicine | Current |
Accepting new patients |
| Public Hospital District No 4 King County Washington | Current |
Accepting new patients | |
| Cep America LLC | Emergency Medicine | Current |
Accepting new patients |
| Public Hospital District No 4 King County Washington | Current |
Accepting new patients | |
| Cep America LLC | Emergency Medicine | Current |
Accepting new patients |
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
| Puget Sound Physicians PLLC | Emergency Medicine | Current |
Accepting new patients |
| Clallam County Public Hospital District No 1 | Past | Accepting new patients | |
| Public Hospital District No 4, King County Wa | Past | Accepting new patients |
Locations
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141
21601 76th Ave W
Edmonds, WA 98026
Phone (425) 640-4000
1117 Spring St
Friday Harbor, WA 98250
Phone (360) 378-1738
3011 196th St SW
Lynnwood, WA 98036
Phone (425) 688-5759
6912 220th St SW
Ste 113
Mountlake Terrace, WA 98043
Phone (425) 361-7670
1411 4th Ave
Seattle, WA 98101
Phone (253) 271-9720
9801 Frontier Ave SE
Snoqualmie, WA 98065
Phone (425) 831-2300
Interoperability endpoints
- aselvam390318@direct.multicare.org
- anand.selvam.1@13869.direct.athenahealth.com
- https://api.qualifacts.org/api/fhir/forkshospital/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 127708 | AK | |
| Emergency Medicine Physician | 207P00000X | 57.02092 | OH | |
| Emergency Medicine Physician | 207P00000X | 125630 | OH | |
| Emergency Medicine Physician | 207P00000X | 55175 | CT | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | MD60824986 | WA | Yes |
Addresses
Primary practice location
530 Bogachiel Way
Forks, WA 98331
Mailing address
1100 University St Apt 1701
Seattle, WA 98101-3189
Phone (610) 348-0462
Other practice location 1
333 Cedar St
Yale Medical School
New Haven, CT 06510-3206
Phone (203) 785-4404
Other practice location 2
401 15th Ave SE
Puyallup, WA 98372-3715
Phone (253) 697-4000
Other practice location 3
6912 220th St SW Ste 113
Mountlake Terrace, WA 98043-2174
Phone (425) 553-0937
Other providers in Forks, WA
- Bruce Robinson
- Vernon Rondeau
- Ann E Rowe
- Juan R Ruiz
- Sarah Sanders
- Susan Lee Shane
- John M Shima
- Gregory Michael Smith
- Josuah Tilus
- Cheri Ann Tinker
All providers in Forks, WA · Emergency Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.