Individual provider Active NPI

Ajay Koti

  • Pediatrics Physician
  • Seattle, WA
National Provider Identifier
1033640982
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD61156816 Issued in WA
Practice address
1959 NE Pacific St.
Seattle, WA 98195-0001
Phone
(206) 520-5000
NPI assigned
Mar 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child Abuse Pediatrics Physician 2080C0008X MD61156816 WA
Pediatrics Physician 208000000X MD61156816 WA Primary

Addresses

Primary practice location

1959 NE Pacific St.
Seattle, WA 98195-0001

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Other practice location 1

4400 37th Ave S
Seattle, WA 98118-1609
Phone (206) 548-5850

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
I20240820003669 WA Practitioner - Pediatric Medicine 1658642905 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Health CurrentSince Oct 7, 2024 Accepting new patients
Neighborcare Health CurrentSince Oct 7, 2024 Accepting new patients
The Association of Chrmc and University Physicians Pediatrics CurrentSince Aug 6, 2024 Accepting new patients
Neighborcare Health Current Accepting new patients
The Association of University Physicians CurrentSince Sep 18, 2024 Accepting new patients
Association of CHMC and University Physicians Pediatrics CurrentSince Aug 6, 2024 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

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

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

Interoperability endpoints

  • Direct secure messaging: akoti1328624@direct.ehre.uwmedicine.org
  • Direct secure messaging: akoti148261@direct.seattlechildrens.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1033640982",
    "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": [
        {
            "address_1": "4400 37th Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981181609",
            "country_code": "US",
            "telephone_number": "206-548-5850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTI",
        "first_name": "AJAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "WA",
            "license": "MD61156816",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61156816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.