Individual provider Active NPI

Adithya Krishna Sona Vegaraju, MD

  • Internal Medicine Physician
  • Seattle, WA
National Provider Identifier
1245084045
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
61545612 Issued in WA
Practice address
1959 NE Pacific Street Box 356421
Seattle, WA 98195-6421
Phone
(206) 543-3605
NPI assigned
Apr 16, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 61545612 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X WA

Addresses

Primary practice location

1959 NE Pacific Street Box 356421
Seattle, WA 98195-6421

Mailing address

1959 NE Pacific Street Box 356421
Seattle, WA 98195-6421
Phone (206) 543-3605

Other names 1

  • Adithya Vegaraju Professional name

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
I20240625004237 WA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3870037385

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61545612WAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1245084045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC STREET BOX 356421",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956421",
            "telephone_number": "206-543-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC STREET BOX 356421",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956421",
            "telephone_number": "206-543-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGARAJU",
        "first_name": "ADITHYA KRISHNA SONA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "61545612",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADITHYA",
            "last_name": "VEGARAJU",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.