Individual provider Active NPI

Caroline Nduta Nduati

  • Psychiatric/Mental Health Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1194407585
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61430821 Issued in WA
Practice address
4801 176TH St E # K-308
Tacoma, WA 98446-2810
Phone
(770) 572-2098
NPI assigned
Aug 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61430821 WA Primary

Addresses

Primary practice location

4801 176TH St E # K-308
Tacoma, WA 98446-2810

Mailing address

4801 176TH St E # K-308
Tacoma, WA 98446-2810
Phone (770) 572-2098

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231117002264 WA Practitioner - Nurse Practitioner 1759739444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

950 Broadway
Suite 404
Tacoma, WA 98402-4454
Phone (425) 640-7009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Psychiatric/Mental Health CurrentSince Nov 3, 2023 Accepting new patients
Serenity Behavioral Health PLLC CurrentSince Feb 18, 2024 Accepting new patients

Locations

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

21907 64th Ave W
Ste 200
Mountlake Terrace, WA 98043
Phone (410) 258-3698

320 NE 97th St
Ste A
Seattle, WA 98115
Phone (206) 323-8113

950 Broadway
Ste 404
Tacoma, WA 98402
Phone (206) 774-8557

Organizations & group practices 2

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": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1194407585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 176TH ST E # K-308",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984462810",
            "telephone_number": "770-572-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 176TH ST E # K-308",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984462810",
            "telephone_number": "770-572-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDUATI",
        "first_name": "CAROLINE",
        "middle_name": "NDUTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61430821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.