Individual provider Active NPI

Vijay Vanchinathan, M.D.

  • Dermatology Physician
  • Tacoma, WA
National Provider Identifier
1225473416
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
60898358 Issued in WA
Practice address
209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone
(253) 596-3300
NPI assigned
May 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 67721-20 WI
Dermatology Physician 207N00000X 60898358 WA Primary

Addresses

Primary practice location

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265

Mailing address

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300

Other practice location 1

3301 Cranberry Blvd
Weston, WI 54476-5216
Phone (715) 393-3900

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170922000322 WI Practitioner - Dermatology 9335413848 Reassigns benefits to 2 organizations
I20190618002680 WA Practitioner - Dermatology 9335413848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Rochester School of Medicine and Dentistry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions15
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60898358WAMDDermatology Physician
67721-20WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince May 20, 2019 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Sep 1, 2017 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Sep 1, 2017 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Sep 1, 2017 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince May 20, 2019 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Sep 1, 2017 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

1120 Pine St
Stanley, WI 54768
Phone (715) 644-5530

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

3301 Stanley St
Stevens Point, WI 54481
Phone (715) 268-5500

3301 Cranberry Blvd
Weston, WI 54476
Phone (715) 393-2100

Interoperability endpoints

  • Direct secure messaging: vvanchinathan230839@ghc.direct-ci.net

Organizations & group practices 6

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": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1225473416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054265",
            "telephone_number": "253-596-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054265",
            "telephone_number": "253-596-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 Cranberry Blvd",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "WI",
            "postal_code": "544765216",
            "country_code": "US",
            "telephone_number": "715-393-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANCHINATHAN",
        "first_name": "VIJAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-02",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "67721-20",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "60898358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "209 Martin Luther King Jr Way",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.