Individual provider Active NPI

Srinivas Murthy Mascal Gangadharaiah, MD

  • Internal Medicine Physician
  • Kennewick, WA
National Provider Identifier
1033488077
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60286888 Issued in WA
Practice address
7103 W Grandridge Blvd Ste D
Kennewick, WA 99336-6713
Phone
(509) 676-2160
NPI assigned
Dec 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125055614 IL
Internal Medicine Physician 207R00000X MD60286888 WA Primary

Addresses

Primary practice location

7103 W Grandridge Blvd Ste D
Kennewick, WA 99336-6713

Mailing address

7103 W Grandridge Blvd Ste D
Kennewick, WA 99336-6713
Phone (509) 676-2160

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130129000064 WA Practitioner - Internal Medicine 6002060027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1200 N 14TH Ave
Suite 245
Pasco, WA 99301-4078
Phone (509) 676-2160

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125055614ILMDInternal Medicine Physician
MD60286888WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Comprehensive Health PLLC CurrentSince Oct 20, 2022 Accepting new patients
Tri Cities Community Health Past Accepting new patients

Locations

7103 W Grandridge Blvd
Ste D
Kennewick, WA 99336
Phone (509) 676-2160

1200 N 14th Ave
Ste 245
Pasco, WA 99301
Phone (509) 547-9521

Organizations & group practices 2

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 4

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": "1324339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1033488077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7103 W GRANDRIDGE BLVD STE D",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366713",
            "telephone_number": "509-676-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7103 W GRANDRIDGE BLVD STE D",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366713",
            "telephone_number": "509-676-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCAL GANGADHARAIAH",
        "first_name": "SRINIVAS MURTHY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-20",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125055614",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60286888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.