Rupin Raj Thakkar, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

MD00046476 Issued in WA

Practice address

21600 Highway 99
Suite 290
Edmonds, WA 98026-8012

Phone

(425) 778-0191

Fax

(425) 672-2110

NPI assigned

Sep 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rthakkar1043406@wm.providencedirect.org
• Direct secure messaging: rthakkar127504@direct.seattlechildrens.org

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.

• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1831139724
  Medicare reassignment NPD
• Swedish Health Services

  • Physical Therapist
  • Seattle, WA
  • NPI 1619680840
  NPD

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1164528790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 HIGHWAY 99",
            "address_2": "SUITE 290",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268012",
            "telephone_number": "425-778-0191",
            "fax_number": "425-672-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 HIGHWAY 99",
            "address_2": "SUITE 290",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268012",
            "telephone_number": "425-778-0191",
            "fax_number": "425-672-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "RUPIN",
        "middle_name": "RAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WA",
            "license": "MD00046476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rthakkar1043406@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21600 Highway 99",
            "address_2": "Suite 290",
            "city": "Edmonds",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980268012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christine Y Terry, PHYSCIANS ASSISTANT
• Jitka Fiala Terry, OTR/L
• Donald Tesch, M.D.
• Susan Maltz Tesch, M.S., L.M.F.T.
• Seble Embay Tesfay, REGISTERED NURSE
• Julianne Thal, NAC
• Carrie Thayer, MA, LMFT
• The Awaken Center of Integrative Medicine NFP Foundation
• The Center for Counseling and Health Resources, Inc.
• The Charis Clinic PLLC

• Pediatric Adolescent Medicine Physician in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Pediatric Adolescent Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.

Verify at the official NPI Registry.