Individual provider Active NPI

Arezou Amidi, DPM

  • Podiatrist
  • Moses Lake, WA
National Provider Identifier
1992144398
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO60793680 Issued in WA
Practice address
1550 S Pioneer Way Ste 300
Moses Lake, WA 98837-4637
Phone
(509) 793-9783
Fax
(509) 764-3253
NPI assigned
Jun 19, 2013
Last updated
May 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO60793680 WA Primary

Addresses

Primary practice location

1550 S Pioneer Way Ste 300
Moses Lake, WA 98837-4637

Mailing address

1616 S Pioneer Way
Moses Lake, WA 98837-2487
Phone (509) 793-9715

Other identifiers 1

IdentifierTypeStateIssuer
2088625MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aamidi1203463@wm.providencedirect.org 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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171116002498 WA Practitioner - Podiatry 9830493147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1550 S Pioneer Way
Moses Lake, WA 98837-4613
Phone (509) 793-9780

1550 S Pioneer Way
Suite 115
Moses Lake, WA 98837-4618

2000 S Clover Dr
Moses Lake, WA 98837-4417
Phone (509) 765-5606

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue15
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO60793680WAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grant County Public Hospital District 1 CurrentSince Oct 14, 2017 Accepting new patients
Grant County Public Hospital District 1 CurrentSince Apr 20, 2021 Accepting new patients
Grant County Public Hospital District 1 CurrentSince Oct 14, 2017 Accepting new patients
Davie Urgent Care LLC Past Accepting new patients

Locations

1550 S Pioneer Way
Moses Lake, WA 98837
Phone (509) 793-9780

1550 S Pioneer Way
Ste 300
Moses Lake, WA 98837
Phone (509) 793-9783

1550 S Pioneer Way
Ste 365
Moses Lake, WA 98837
Phone (509) 764-6522

1616 S Pioneer Way
Moses Lake, WA 98837

2000 S Clover Dr
Moses Lake, WA 98837
Phone (509) 765-5606

660 S Coolidge St
Moses Lake, WA 98837

801 E Wheeler Rd
Moses Lake, WA 98837
Phone (509) 765-5606

8420 Aspi Blvd
Moses Lake, WA 98837
Phone (509) 793-9781

Interoperability endpoints

  • Direct secure messaging: aamidi1203463@wm.providencedirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1992144398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 S PIONEER WAY",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372487",
            "telephone_number": "509-793-9715",
            "fax_number": "509-764-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S PIONEER WAY STE 300",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988374637",
            "telephone_number": "509-793-9783",
            "fax_number": "509-764-3253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIDI",
        "first_name": "AREZOU",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO60793680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2088625",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aamidi1203463@wm.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "EPIC EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1550 S Pioneer Way Ste 300",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988374637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

Verify at the official NPI Registry.