Individual provider Active NPI

Gautam Naresh Mankaney, MD

  • Gastroenterology Physician
  • Seattle, WA
National Provider Identifier
1053677310
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD61110329 Issued in WA
Practice address
1100 9TH Ave
Seattle, WA 98101-2756
Phone
(206) 223-2319
Fax
(206) 341-1405
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35.126253 OH
Gastroenterology Physician 207RG0100X MD61110329 WA Primary

Addresses

Primary practice location

1100 9TH Ave
Seattle, WA 98101-2756

Mailing address

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-2319

Other practice location 1

200 Lothrop St
Suite N713
Pittsburgh, PA 15213-2536
Phone (412) 692-4700

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
I20201210000458 WA Practitioner - Gastroenterology 8729361613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Ohio State University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-6600

Hospital & facility affiliations

  • Virginia Mason Medical Center Hospital, Seattle, WA, CCN 500005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy97
Upper gastrointestinal (GI) endoscopy for acid reflux117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61110329WAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center Gastroenterology CurrentSince Jan 14, 2021 Accepting new patients
Virginia Mason Medical Center Gastroenterology CurrentSince Jan 14, 2021 Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Gastroenterology Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

11695 NE 4th St
Bellevue, WA 98004
Phone (425) 637-1855

33501 1st Way S
Federal Way, WA 98003
Phone (253) 838-2400

19116 33rd Ave W
Lynnwood, WA 98036
Phone (425) 712-7900

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/66ad9a50-d7f7-4c21-b933-2ba90047388e/

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.

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1053677310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-2319",
            "fax_number": "206-341-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-2319",
            "fax_number": "206-341-1405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Lothrop St",
            "address_2": "Suite N713",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152132536",
            "country_code": "US",
            "telephone_number": "412-692-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANKANEY",
        "first_name": "GAUTAM",
        "middle_name": "NARESH",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35.126253",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD61110329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.