Pediatrix Cardiology of Washington, P.C.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

Legal business name

PEDIATRIX CARDIOLOGY OF WASHINGTON, P.C.

Practice address

314 Martin Luther King Jr Way
Ste. 303
Tacoma, WA 98405-4250

Phone

(253) 396-4868

Fax

(253) 396-4870

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Nanette Sanders

Title

Assistant Secretary

Phone

(800) 243-3839

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 23

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

• Jennie Michelle Allen-Rich, MD

  • Pediatric Cardiology Physician
  • Tacoma, WA
  • NPI 1194980193
  Medicare reassignment NPD
• Christopher Anthony Bellotti, M.D.

  • Pediatric Cardiology Physician
  • Everett, WA
  • NPI 1023261989
  Medicare reassignment NPD
• Rakesh Roshan D'Souza, M.D

  • Pediatric Cardiology Physician
  • Tacoma, WA
  • NPI 1912210899
  Medicare reassignment NPD
• K. David Epley, M.D.

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Kirkland, WA
  • NPI 1588642003
  Medicare reassignment NPD
• Kimberly A. Krabill, MD

  • Pediatric Cardiology Physician
  • Seattle, WA
  • NPI 1508937509
  Medicare reassignment NPD
• Joan Lee, M.D.

  • Pediatric Cardiology Physician
  • Yakima, WA
  • NPI 1619362274
  Medicare reassignment NPD
• Vy Thuy Mai, O.D

  • Pediatric Optometrist
  • Kirkland, WA
  • NPI 1831597715
  Medicare reassignment NPD
• John Patrick McCloskey, MD

  • Pediatrics Physician
  • Tacoma, WA
  • NPI 1245285501
  Medicare reassignment NPD
• Aida Mekouar, OD

  • Optometrist
  • Seattle, WA
  • NPI 1154661791
  Medicare reassignment NPD
• Matthew V. Park, M.D.

  • Pediatric Cardiology Physician
  • Tacoma, WA
  • NPI 1699875716
  Medicare reassignment NPD
• Nefthi Sandeep, M.D.

  • Pediatric Cardiology Physician
  • Tacoma, WA
  • NPI 1922269661
  Medicare reassignment NPD
• Jeannette Stallworth, MD

  • Ophthalmology Physician
  • Seattle, WA
  • NPI 1194285882
  Medicare reassignment NPD

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1164445367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232843",
            "telephone_number": "800-243-3839",
            "fax_number": "844-686-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 MARTIN LUTHER KING JR WAY",
            "address_2": "STE. 303",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054250",
            "telephone_number": "253-396-4868",
            "fax_number": "253-396-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIX CARDIOLOGY OF WASHINGTON, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "NANETTE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "800-243-3839"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164445367",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164445367",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG20WA",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lynn Pederson, LMP
• John Patrick Pedey-Braswell, PHARMD, BCPP, BCPS
• Pediatric Dental Care Center
• Pediatric Neurology Associates PS
• Pediatrics Northwest PS
• Molly Marie Pedraza
• Melissa Anne Pedrozo, EAMP, LAC
• Cecilia Fayth Peebles
• Merritt Edward Peele, DPT
• Luiza Miranda Pegado, LPN

• Pediatric Cardiology Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Pediatric Cardiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.