MR. SAMIOLLAH GHOLAM (M.D) – Internal Medicine Physician, NPI 1326457904
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
384 INTERNAL MEDICINE in VT
Provider Addresses for MR. SAMIOLLAH GHOLAM (M.D)
1115 SE 164TH AVE DEPT 358
VANCOUVER, WA 986838004
Phone: (360) 729-1462
Fax: (360) 729-3104
Type: Mailing
353 BLAIR PARK RD
WILLISTON, VT 054957530
Phone: (802) 847-1470
Type: Location
4545 CORDATA PKWY STE 2A
BELLINGHAM, WA 98226
Phone: (360) 738-2200
Fax: (360) 752-5682
Type: Location
28585 VIA ROBLE
TEMECULA, CA 925916548
Phone: (305) 904-9456
Type: Mailing
44045 MARGARITA RD STE 103
TEMECULA, CA 925922729
Phone: (951) 880-0701
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $139.
Total Amount is formed as General ($139) + Research ($0) + Ownership ($0) = $139.
Last reported payment date: 2024-08-01 • Largest payer in this snapshot: Amgen Inc. ($118).
Total Amount
$139
General + Research + Ownership
Payments
2
Total payment records
General Amount
$139
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-01
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Amgen Inc. | $118 |
| Astellas Pharma US Inc | $21 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-12-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171129003702 | I | Internal Medicine | CA | TBD |
| I20241210003455 | I | Internal Medicine | VT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98683)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | VT | |
| Nurse Practitioner | MA | |
| - | VT | |
| - | VT | |
| - | VT | |
| - | CT | |
| - | VT | |
| - | IN | |
| - | VT | |
| - | VT |
Reviews
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