NPIMap

Individual provider Active NPI

Preeti Kondal, D.O.

  • Infectious Disease Physician
  • Olympia, WA
National Provider Identifier
1205099181
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
OP60098127 Issued in WA
Practice address
3525 Ensign Rd NE Ste R
PMG SW Wa Olympia Infectious Diseases
Olympia, WA 98506-5065
Phone
(360) 493-4001
Fax
(360) 455-7405
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X OP60098127 WA Primary

Addresses

Primary practice location

3525 Ensign Rd NE Ste R
PMG SW Wa Olympia Infectious Diseases
Olympia, WA 98506-5065

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455

Other identifiers 1

IdentifierTypeStateIssuer
OP60098127OtherWASTATE LICENCE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pbhalla191088@wm.providencedirect.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100514000890 WA Practitioner - Infectious DiseasePractitioner - Internal Medicine 8820126600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

3525 Ensign Rd NE
Suite F
Olympia, WA 98506-5065
Phone (360) 493-4001

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 493-4083

525 Lilly Rd NE
Olympia, WA 98506-5101

Hospital & facility affiliations

  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Grays Harbor Community Hospital Hospital, Aberdeen, WA, CCN 500031
  • Mason General Hospital & Family of Clinics Hospital, Shelton, WA, CCN 501336
  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Sep 20, 2012 Accepting new patients

Locations

3525 Ensign Rd NE
Ste R
Olympia, WA 98506
Phone (360) 459-3663

3525 Ensign Rd NE
Ste F
Olympia, WA 98506
Phone (360) 438-3029

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

Organizations & group practices 1

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.

Hospital & facility affiliations 9

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1205099181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 ENSIGN RD NE STE R",
            "address_2": "PMG SW WA OLYMPIA INFECTIOUS DISEASES",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065065",
            "telephone_number": "360-493-4001",
            "fax_number": "360-455-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDAL",
        "first_name": "PREETI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WA",
            "license": "OP60098127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "OP60098127",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pbhalla191088@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3525 Ensign Rd NE Ste R",
            "address_2": "PMG SW WA Olympia Infectious Diseases",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.