Individual provider Active NPI

Rajesh Kumar Kandasamy, MD

  • Pulmonary Disease Physician
  • Tacoma, WA
National Provider Identifier
1053509976
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD60330994 Issued in WA
Practice address
1708 Yakima Ave Ste 300
Tacoma, WA 98405-5309
Phone
(253) 363-8700
Fax
(360) 697-2514
NPI assigned
Oct 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD60330994 WA
Sleep Medicine (Internal Medicine) Physician 207RS0012X MD60330994 WA
Pulmonary Disease Physician 207RP1001X MD60330994 WA Primary

Addresses

Primary practice location

1708 Yakima Ave Ste 300
Tacoma, WA 98405-5309

Mailing address

1708 Yakima Ave Ste 300
Tacoma, WA 98405-5309
Phone (253) 363-8700

Other identifiers 1

IdentifierTypeStateIssuer
2030361MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rkandasamy44152@fhsce.catholichealth.net Direct

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
I20131011001422 WA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7113151804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 426-6341

1608 S J St
Tacoma, WA 98405-4930

1617 S J St
Tacoma, WA 98405-4930
Phone (253) 426-6306

1708 Yakima Ave
Tacoma, WA 98405-5307
Phone (253) 272-2224

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

34503 9TH Ave S
Federal Way, WA 98003-8726

34515 9TH Ave S
Federal Way, WA 98003-6761
Phone (253) 944-7977

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
St Francis Community Hospital Past Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

34509 9th Ave S
Ste 104
Federal Way, WA 98003
Phone (253) 572-5140

1708 Yakima Ave
Ste 300
Tacoma, WA 98405
Phone (253) 363-8700

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

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 9

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": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1053509976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE STE 300",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055309",
            "telephone_number": "253-363-8700",
            "fax_number": "360-697-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE STE 300",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055309",
            "telephone_number": "253-363-8700",
            "fax_number": "360-697-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDASAMY",
        "first_name": "RAJESH",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "MD60330994",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "WA",
            "license": "MD60330994",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD60330994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030361",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkandasamy44152@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1708 Yakima Ave Ste 300",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.