Individual provider Active NPI

Vimal Siva Gunasekaran, MD

  • Diagnostic Radiology Physician
  • Seattle, WA
National Provider Identifier
1144801812
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ML61440721 Issued in WA
Practice address
1959 NE Pacific St Radiology
Seattle, WA 98195-0001
Phone
(206) 598-8039
NPI assigned
Apr 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ML61440721 WA Primary

Addresses

Primary practice location

1959 NE Pacific St Radiology
Seattle, WA 98195-0001

Mailing address

1959 NE Pacific St Radiology
Seattle, WA 98195-0001

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
I20230808002590 WA Order and Referring Only - Diagnostic RadiologyPractitioner - Diagnostic Radiology 6204298227

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1144801812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST RADIOLOGY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST RADIOLOGY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-598-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNASEKARAN",
        "first_name": "VIMAL",
        "middle_name": "SIVA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "ML61440721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.