NPIMap

Organization Active NPI

Cascade Kidney Specialists

  • Nephrology Physician
  • Bellevue, WA
National Provider Identifier
1124458310
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
CASCADE KIDNEY SPECIALISTS
Practice address
Cascade Kidney Specialists
1370 116TH Ave NE Suite 209
Bellevue, WA 98004-3825
Phone
(425) 453-8406
Fax
(425) 453-4173
NPI assigned
Nov 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Authorized official

Name
Dr. Madhuri Kandala, MDNPI 1952494874
Title
Owner
Phone
(425) 453-8406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

Cascade Kidney Specialists
1370 116TH Ave NE Suite 209
Bellevue, WA 98004-3825

Mailing address

Cascade Kidney Specialists
1370 116TH Ave NE Suite 209
Bellevue, WA 98004-3825
Phone (425) 453-8406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140403000867 WA Part B Supplier - Clinic/Group Practice 0446482533 Receives reassigned benefits from 8 practitioners
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Locations

1370 116th Ave NE
Ste 209
Bellevue, WA 98004
Phone (425) 453-8406

11327 NE 120th St
Kirkland, WA 98034
Phone (206) 720-3816

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561680000000",
    "number": "1124458310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CASCADE KIDNEY SPECIALISTS",
            "address_2": "1370 116TH AVE NE SUITE 209",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043825",
            "telephone_number": "425-453-8406",
            "fax_number": "425-453-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CASCADE KIDNEY SPECIALISTS",
            "address_2": "1370 116TH AVE NE SUITE 209",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043825",
            "telephone_number": "425-453-8406",
            "fax_number": "425-453-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE KIDNEY SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-25",
        "last_updated": "2019-06-28",
        "status": "A",
        "authorized_official_last_name": "KANDALA",
        "authorized_official_first_name": "MADHURI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-453-8406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.