Individual provider Active NPI

Priyanka Malini Ravindran, MD

  • Emergency Medicine Physician
  • Everett, WA
National Provider Identifier
1053940916
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD61390230 Issued in WA
Practice address
1321 Colby Ave
Everett, WA 98201-1665
Phone
(425) 261-2000
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD61390230 WA Primary

Addresses

Primary practice location

1321 Colby Ave
Everett, WA 98201-1665

Mailing address

15833 Mill Creek Blvd # 12010
Mill Creek, WA 98012-1200
Phone (425) 259-0212

Other practice location 1

Summa Health/Emergency Medicine Residency
525 East Market St.
Akron, OH 44304
Phone (330) 375-3361

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
I20230816001055 WA Practitioner - Emergency Medicine 2264894781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians
North Sound Emergency Medicine PCGroup PAC ID 5496646754, 38 clinicians

Practice addresses (Care Compare)

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

1700 13TH St
Everett, WA 98201-1689
Phone (425) 259-0212

4112 Harbour Pointe Blvd SW
Suite 100
Mukilteo, WA 98275-5457
Phone (425) 347-6330

Hospital & facility affiliations

  • Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Aug 1, 2023 Accepting new patients
Providence Health & Services-Washington CurrentSince Aug 1, 2023 Accepting new patients
North Sound Emergency Medicine PC Emergency Medicine CurrentSince Aug 16, 2023 Accepting new patients
Providence Health & Services-Wa Past Accepting new patients

Locations

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

1700 13th St
Everett, WA 98201
Phone (425) 252-0895

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

Organizations & group practices 4

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 2

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1053940916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15833 MILL CREEK BLVD # 12010",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121200",
            "telephone_number": "425-259-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011665",
            "telephone_number": "425-261-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Summa Health/Emergency Medicine Residency",
            "address_2": "525 East Market St.",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "44304",
            "country_code": "US",
            "telephone_number": "330-375-3361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVINDRAN",
        "first_name": "PRIYANKA",
        "middle_name": "MALINI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61390230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.