Individual provider Active NPI

Arnulfo T Deray, MD

  • Internal Medicine Physician
  • Richland, WA
National Provider Identifier
1063470037
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00049111 Issued in WA
Practice address
888 Swift Blvd
Richland, WA 99352-3514
Phone
(509) 946-4611
Fax
(509) 942-2185
NPI assigned
May 1, 2006
Last updated
May 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00049111 WA Primary
Internal Medicine Physician 207R00000X 227104 MA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD00049111 WA

Addresses

Primary practice location

888 Swift Blvd
Richland, WA 99352-3514

Mailing address

560 Gage Blvd
Suite 203
Richland, WA 99352
Phone (509) 942-3627

Other identifiers 2

IdentifierTypeStateIssuer
8509499MedicaidWA
0242332OtherWALABOR & INDUSTRIES

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aderay1107164@wm.providencedirect.org 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
I20080404000041 WA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2860495462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

1135 Jadwin Ave
Richland, WA 99352-3434
Phone (509) 942-3300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227104MAMDInternal Medicine Physician
MD00049111WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Kadlec Regional Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Kadlec Regional Medical Center Internal Medicine Current Accepting new patients
Baystate Medical Practices, Inc Internal Medicine Past Accepting new patients

Locations

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

560 Gage Blvd
Ste 203
Richland, WA 99352
Phone (509) 942-3286

780 Swift Blvd
Ste 130
Richland, WA 99352
Phone (509) 942-3244

800 Swift Blvd
Richland, WA 99352
Phone (509) 943-1211

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

945 Goethals Dr
Ste 200
Richland, WA 99352
Phone (509) 942-2555

Interoperability endpoints

  • Direct secure messaging: aderay1107164@wm.providencedirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1063470037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 GAGE BLVD",
            "address_2": "SUITE 203",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 SWIFT BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523514",
            "telephone_number": "509-946-4611",
            "fax_number": "509-942-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERAY",
        "first_name": "ARNULFO",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00049111",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "227104",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "MD00049111",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8509499",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0242332",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aderay1107164@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "888 Swift Blvd",
            "city": "Richland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993523514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.