Individual provider Active NPI

Kusum Paudel, MD

  • Student in an Organized Health Care Education/Training Program
  • Vancouver, WA
National Provider Identifier
1174363691
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2211 NE 139TH S
Vancouver, WA 98686
Phone
(360) 397-1985
NPI assigned
May 31, 2024
Reactivated
Aug 14, 2025
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

2211 NE 139TH S
Vancouver, WA 98686

Mailing address

2211 NE 139TH S
Vancouver, WA 98686
Phone (360) 397-1985

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
I20250922003953 WA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4385149319

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": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1174363691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 NE 139TH S",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98686",
            "telephone_number": "360-397-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 NE 139TH S",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98686",
            "telephone_number": "360-397-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUDEL",
        "first_name": "KUSUM",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-31",
        "last_updated": "2025-08-14",
        "deactivation_date": "2024-12-12",
        "reactivation_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.