Active NPI
Parvathi Mudigonda, MD
- Cardiovascular Disease Physician
- Tacoma, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MD60947017
- Practice address
- 209 Martin Luther King Jr Way
Tacoma, WA 98405-4265 - Phone
- (253) 596-3300
- Fax
- (253) 596-3301
- NPI assigned
- Apr 24, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD60947017 | WA | |
| Cardiovascular Disease Physician | 207RC0000X | MD60947017 | WA | Primary |
Addresses
Primary practice location
209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Mailing address
PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700
Other practice location 1
1959 NE Pacific St
Seattle, WA 98195-3021
Phone (206) 520-5000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190705001039 | WA | Practitioner - Cardiovascular Disease (Cardiology) | 8123312287 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Providence Health & Services- Washington | Current | Accepting new patients | |
| Providence Health & Services - Washington | Current | Accepting new patients |
Locations
1330 Rockefeller Ave
Ste 310
Everett, WA 98201
Phone (425) 261-4925
4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
WA
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1669619870
-
- Family Medicine Physician
- Everett, WA
- NPI 1821249939
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685577600000",
"number": "1104184480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 50095",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981455095",
"telephone_number": "206-520-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 MARTIN LUTHER KING JR WAY",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054265",
"telephone_number": "253-596-3300",
"fax_number": "253-596-3301"
}
],
"practiceLocations": [
{
"address_1": "1959 NE Pacific St",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981953021",
"country_code": "US",
"telephone_number": "206-520-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MUDIGONDA",
"first_name": "PARVATHI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-24",
"last_updated": "2023-06-01",
"certification_date": "2023-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD60947017",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "WA",
"license": "MD60947017",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "209 Martin Luther King Jr Way",
"city": "Tacoma",
"state": "WA",
"country_code": "US",
"postal_code": "984054265",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.