Individual provider Active NPI

Ravi D'Cruz, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Seattle, WA
National Provider Identifier
1225475916
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
MD60942771 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-2401
Phone
(206) 520-5000
NPI assigned
Jun 4, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LP02937 RI
Neonatal-Perinatal Medicine Physician 2080N0001X MD60942771 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-2401

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Other identifiers 1

IdentifierTypeStateIssuer
1225475916MedicaidWA

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
I20190620001143 WA Practitioner - Pediatric Medicine 2163649708 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60942771WAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Association of CHMC and University Physicians Pediatrics CurrentSince May 21, 2019 Accepting new patients
The Association of Chrmc and University Physicians Pediatrics CurrentSince May 21, 2019 Accepting new patients
Swedish Edmonds Past Accepting new patients
Swedish Health Services Past Accepting new patients
Overlake Medical Center & Clinics Past Accepting new patients

Locations

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

Organizations & group practices 5

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": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1225475916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981952401",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'CRUZ",
        "first_name": "RAVI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-04",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "LP02937",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "WA",
            "license": "MD60942771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225475916",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.