NPIMap

Individual provider Active NPI

Venkatachala Mohan, MD

  • Gastroenterology Physician
  • Bellevue, WA
National Provider Identifier
1194704106
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
37468 Issued in WA
Practice address
1135 116TH Ave NE
#560
Bellevue, WA 98004
Phone
(425) 454-4768
Fax
(425) 462-8021
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 50607 MT
Gastroenterology Physician 207RG0100X 37468 WA Primary

Addresses

Primary practice location

1135 116TH Ave NE
#560
Bellevue, WA 98004

Mailing address

1135 116TH Ave NE
#560
Bellevue, WA 98004
Phone (425) 454-4768

Other identifiers 2

IdentifierTypeStateIssuer
8248411MedicaidWA
141895OtherWALABOR & INDUSTRIES

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MT, CA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20080407000037 WA Practitioner - Gastroenterology 9537252754 Reassigns benefits to 2 organizations
I20160920001390 MT Practitioner - Gastroenterology 9537252754 Reassigns benefits to 3 organizations
I20240619001032 CA Practitioner - Gastroenterology 9537252754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

1135 116TH Ave NE
Suite 560
Bellevue, WA 98004-4631
Phone (425) 454-4768

320 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 756-3526

4003 Creekside Loop
Yakima, WA 98908-3962
Phone (509) 248-3263

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy110
Upper gastrointestinal (GI) endoscopy for acid reflux160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50607MTMDGastroenterology Physician
37468WAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Dec 5, 2023 Accepting new patients
Washington Gastroenterology PLLC Gastroenterology CurrentSince Dec 15, 2017 Accepting new patients
Washington Gastroenterology PLLC CurrentSince Dec 15, 2017 Accepting new patients
St. Peter's Health CurrentSince Jun 5, 2018 Accepting new patients
St. Peter's Health CurrentSince Jun 5, 2018 Accepting new patients
St Peter's Health Current Accepting new patients
Kalispell Regional Medical Center Inc CurrentSince Mar 1, 2021 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Dec 5, 2023 Accepting new patients
Yakima Valley Memorial Physicians Current Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Benefis Hospitals Inc CurrentSince Apr 15, 2021 Accepting new patients
Confermed of California PC CurrentSince May 7, 2024 Accepting new patients
Kalispell Regional Medical Center, Inc CurrentSince Mar 1, 2021 Accepting new patients
Benefis Hospitals, Inc. CurrentSince Apr 15, 2021 Accepting new patients
Confermed PC Past Accepting new patients

Locations

101 Academy
Ste 100
Irvine, CA 92617
Phone (860) 323-0172

4600 Campus Dr
Ste 203
Newport Beach, CA 92660
Phone (617) 259-5933

11 Silver St
Unit 856
Middletown, CT 06457

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

320 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 752-7441

1135 116th Ave NE
Ste 560
Bellevue, WA 98004
Phone (425) 467-0150

1135 116th Ave NE
Ste 570
Bellevue, WA 98004
Phone (425) 451-7335

1135 116th Ave NE
Ste 400
Bellevue, WA 98004
Phone (425) 454-4644

1135 116th Ave NE
Ste LL160
Bellevue, WA 98004
Phone (425) 289-0577

1301 4th Ave NW
Unit 303
Issaquah, WA 98027
Phone (425) 270-6363

1301 4th Ave NW
Ste 301
Issaquah, WA 98027
Phone (425) 270-6363

17700 SE 272nd St
Ste 420
Kent, WA 98042
Phone (253) 639-9660

1703 S Meridian
Ste 305
Puyallup, WA 98371
Phone (253) 841-3933

1703 S Meridian
Ste 203
Puyallup, WA 98371
Phone (253) 841-3933

1446 Spaulding Ave
Richland, WA 99352
Phone (509) 420-4588

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

4003 Creekside Loop
Yakima, WA 98908
Phone (509) 248-3263

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1194704106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE",
            "address_2": "#560",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-454-4768",
            "fax_number": "425-462-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE",
            "address_2": "#560",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-454-4768",
            "fax_number": "425-462-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAN",
        "first_name": "VENKATACHALA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MT",
            "license": "50607",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "37468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8248411",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "141895",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "320 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.