Individual provider Active NPI

Stephanie Kalila Raghubeer, M.D.

  • Pediatrics Physician
  • Yakima, WA
National Provider Identifier
1134571185
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60948563 Issued in WA
Practice address
2811 Tieton Dr
Yakima, WA 98902-3761
Phone
(509) 575-8452
NPI assigned
Jul 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125-069555 IL
Pediatrics Physician 208000000X MD60948563 WA Primary

Addresses

Primary practice location

2811 Tieton Dr
Yakima, WA 98902-3761

Mailing address

2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8452

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
I20190813000921 WA Practitioner - Pediatric Medicine 6507159241 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-069555ILMDPediatrics Physician
MD60948563WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Pediatrics CurrentSince Jul 6, 2022 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jul 6, 2022 Accepting new patients

Locations

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

Interoperability endpoints

  • Direct secure messaging: sraghubeer137285@direct.multicare.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1134571185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023761",
            "telephone_number": "509-575-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023761",
            "telephone_number": "509-575-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHUBEER",
        "first_name": "STEPHANIE",
        "middle_name": "KALILA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-01",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125-069555",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60948563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.