Individual provider Active NPI

Tarang Prakash Jethwa, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1013412998
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61594735 Issued in WA
Practice address
1959 NE Pacific St.
Seattle, WA 98195-0001
Phone
(206) 520-5000
NPI assigned
Mar 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61594735 WA Primary

Addresses

Primary practice location

1959 NE Pacific St.
Seattle, WA 98195-0001

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, WA2 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

Enrollment IDStateProvider typePAC IDDetails
I20210726001781 MA Practitioner - Family Practice 0042568255 Reassigns benefits to 1 organization
I20240930003336 WA Practitioner - Family Practice 0042568255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

Hospital & facility affiliations

  • Evergreenhealth Home Care Services Home health agency, Kirkland, WA, CCN 507079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc. CurrentSince Jul 19, 2021 Accepting new patients
The Association of University Physicians Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Riverbend Medical Group, Inc CurrentSince Jul 19, 2021 Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

305 Bicentennial Hwy
Springfield, MA 01118
Phone (413) 733-4101

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

1455 NW Leary Way
Ste 250
Seattle, WA 98107
Phone (206) 520-2642

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1521849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1013412998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST.",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETHWA",
        "first_name": "TARANG",
        "middle_name": "PRAKASH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-24",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61594735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.