Nisha Khanal, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61198230 Issued in WA

Practice address

4001 Tieton Dr
Yakima, WA 98908-3345

Phone

(509) 410-0746

Fax

(509) 410-0749

NPI assigned

Sep 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Nisha Khanal Panta Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Physicians Immediate Care & Medical Centers, P.S.

  • Family Medicine Physician
  • Richland, WA
  • NPI 1821002510
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1093290132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5999",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972285999",
            "telephone_number": "541-500-2500",
            "fax_number": "541-500-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083345",
            "telephone_number": "509-410-0746",
            "fax_number": "509-410-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANAL",
        "first_name": "NISHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "2945",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61198230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2192132",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NISHA",
            "last_name": "PANTA",
            "middle_name": "KHANAL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kevin M Harrington, MD, Inc PS
• Keystone Anesthesia Inc
• Ryan Scott Kezele, D.D.S.
• Sahira Khalid
• Mohammad Tariq Khan
• Suneeta Khanwani, MD
• Kamran Khatri
• Shahriar Khezri, MD
• Janani Kidambi, M.D.
• Kids Cavity Prevention Program Inc.

• Physician Assistant in Yakima, WA
• Providers in Yakima, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.