Nisreen Fidda, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MD00044946 Issued in WA

Practice address

3900 Capital Mall Drive SW
Olympia, WA 98502

Phone

(360) 754-5858

Fax

(360) 956-2574

NPI assigned

Mar 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA, AK2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nfidda596811@direct.multicare.org

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.

• The Polyclinic PLLC

  • Audiologist
  • Seattle, WA
  • NPI 1174594634
  Medicare reassignment NPD
• The Polyclinic PLLC

  • Durable Medical Equipment & Medical Supplies
  • Tacoma, WA
  • NPI 1831411487
  NPD
• Cellnetix Labs LLC

  • Clinical Medical Laboratory
  • Everett, WA
  • NPI 1063481570
  NPD (past)
• Cellnetix Pathology, PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Everett, WA
  • NPI 1356310866
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1992764880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3941",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243941",
            "telephone_number": "360-459-7770",
            "fax_number": "360-459-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CAPITAL MALL DRIVE SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98502",
            "telephone_number": "360-754-5858",
            "fax_number": "360-956-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDDA",
        "first_name": "NISREEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD00044946",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OR",
            "license": "MD24504",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "203962",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8412462",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia Ferris, M.S., LMHC
• Jill Ferris, L.M.P.
• Shayni Weston Fesenbek, OTR/L
• Michelle Fetrick, DPT
• Trinity Ann Fewell
• Jack Mark Fields, MD
• Miriam Louise Fields, MD, MPH
• Melanie Figeley, NTP
• Elizabet Figueroa, PHYSICIAN ASSISTANT
• Fihn Med Group Inc

• Anatomic Pathology & Clinical Pathology Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.