Active NPI
Ajay Venkataram
- Internal Medicine Physician
- Tacoma, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD60715854
- Practice address
- 1717 S J St Ste 336
Tacoma, WA 98405-4933 - Phone
- (253) 426-4101
- Fax
- (253) 426-6936
- NPI assigned
- Jun 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD60715854 | WA | Primary |
Addresses
Primary practice location
1717 S J St Ste 336
Tacoma, WA 98405-4933
Mailing address
1810 Summit Pointe Dr
Scranton, PA 18508
Phone (570) 877-3988
Other practice location 1
501 Madison Ave
Scranton, PA 18510
Phone (570) 343-2383
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
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
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300
Hospital & facility affiliations
- St Joseph Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60715854 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| South Sound Inpatient Physicians PLLC | Internal Medicine | Current | Accepting new patients |
| South Sound Inpatient Physicians PLLC | Internal Medicine | Current | Accepting new patients |
| Cogent Healthcare of Washington, PC | Internal Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients |
Locations
5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674
202 N Division St
Auburn, WA 98001
Phone (253) 333-2562
407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021
209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
Interoperability endpoints
- avenkataram4152812@ghc.direct-ci.net
Organizations & group practices 6
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.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
- Internal Medicine Physician
- Vancouver, WA
- NPI 1023285756
-
- Internal Medicine Physician
- Vancouver, WA
- NPI 1861430522
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1124264577
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
-
- Internal Medicine Physician
- Hillsboro, OR
- NPI 1508023789
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1124291117
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1952309098
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666915200000",
"number": "1043625478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1810 SUMMIT POINTE DR",
"city": "SCRANTON",
"state": "PA",
"postal_code": "18508",
"telephone_number": "570-877-3988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S J ST STE 336",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054933",
"telephone_number": "253-426-4101",
"fax_number": "253-426-6936"
}
],
"practiceLocations": [
{
"address_1": "501 Madison Ave",
"address_purpose": "LOCATION",
"city": "Scranton",
"state": "PA",
"postal_code": "18510",
"country_code": "US",
"telephone_number": "570-343-2383",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VENKATARAM",
"first_name": "AJAY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-24",
"last_updated": "2022-10-28",
"certification_date": "2022-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD60715854",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1717 S J St Ste 336",
"city": "Tacoma",
"state": "WA",
"country_code": "US",
"postal_code": "984054933",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.