| Cascade Cardiology LLC | |
|
777 Commercial St Se Suite 130 Salem OR 97301-3421 | |
| (503) 485-4787 | |
| (503) 485-4789 |
| Full Name | Cascade Cardiology LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 777 Commercial St Se, Salem, Oregon |
| Authorized Official Name and Position | Helen Carol Wigstrom (CREDENTIALING AND CONTRACTING SPECI) |
| Authorized Official Contact | 5034854787 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cascade Cardiology LLC 777 Commercial St Se Suite 130 Salem OR 97301-3421 Ph: (503) 485-4787 | Cascade Cardiology LLC 777 Commercial St Se Suite 130 Salem OR 97301-3421 Ph: (503) 485-4787 |
| NPI Number | 1447202668 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 10/14/2022 |
| Certification Date | 10/14/2022 |
| Medicare PECOS PAC ID | 2466446844 |
|---|---|
| Medicare Enrollment ID | O20040408001518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447202668 | NPI | - | NPPES |
| DB8768 | Other | OR | RAILROAD MEDICARE |
| 276218 | Medicaid | OR | |
| 82569100 | Other | OR | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Maziar Azadpour |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730131855 PECOS PAC ID: 6103882923 Enrollment ID: I20060901000021 |
| Provider Name | Ashit G Patel |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1427276757 PECOS PAC ID: 3173606886 Enrollment ID: I20080218000522 |
| Provider Name | Harminder P Gandhok |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053585935 PECOS PAC ID: 5799756243 Enrollment ID: I20090709000340 |
| Provider Name | Kenneth Wayne Lowry |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932773306 PECOS PAC ID: 6204227333 Enrollment ID: I20211229000590 |
| Provider Name | Aswathnarayan R Manandhi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568662385 PECOS PAC ID: 0547386963 Enrollment ID: I20221017002490 |
| Provider Name | Amber Shelly Michaeli |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649893785 PECOS PAC ID: 5597135723 Enrollment ID: I20230105000563 |
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