Ganga Pingili, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

60188439 Issued in WA

Practice address

2835 82ND Ave SE Ste 210
Mercer Island, WA 98040-3055

Phone

(206) 236-3030

Fax

(206) 204-0808

NPI assigned

Jun 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Georiga Dermatology Center, P.C.

  • Dermatology Physician
  • Cumming, GA
  • NPI 1942307160
  NPD

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1235174855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 82ND AVE SE STE 210",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403055",
            "telephone_number": "206-236-3030",
            "fax_number": "206-204-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 82ND AVE SE STE 210",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403055",
            "telephone_number": "206-236-3030",
            "fax_number": "206-204-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINGILI",
        "first_name": "GANGA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "60188439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621341781A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GEORGIA",
            "identifier": "003130",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex Toan Pham
• Carter Ryan Phillips, PT, DPT
• Edyth Darlene Phillips, M.D.
• Ryan Cory Phillips, RPH
• Dean Picozzi, MLP
• Angel CHI CHI Planells, MS, RDN, FAND
• PNC Podiatry of Washington PLLC
• Lisa Porad, M.S., L.AC
• Chelsey Faith Preston, LMP
• Qliance Medical Group of Wa

• Medical Physician Assistant in Mercer Island, WA
• Providers in Mercer Island, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.