Individual provider Active NPI

Katerina G Riabova, MD

  • Psychiatry Physician
  • Redmond, WA
National Provider Identifier
1265486880
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD00041397 Issued in WA
Practice address
2007 152ND Ave NE #13
Redmond, WA 98052-5521
Phone
(425) 633-0119
Fax
(425) 746-2308
NPI assigned
May 19, 2006
Last updated
Aug 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X MD00041397 WA
Psychiatry Physician 2084P0800X MD00041397 WA Primary

Addresses

Primary practice location

2007 152ND Ave NE #13
Redmond, WA 98052-5521

Mailing address

2007 152ND Ave NE #13
Redmond, WA 98052-5521
Phone (425) 633-0119

Other identifiers 1

IdentifierTypeStateIssuer
1119734MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00041397WAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Katerina G. Riabova, M.D. P.S. PastSince Apr 1, 2004 Accepting new patients
Cascade Psychiatric Services, PLLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1265486880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 152ND AVE NE #13",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525521",
            "telephone_number": "425-633-0119",
            "fax_number": "425-746-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 152ND AVE NE #13",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525521",
            "telephone_number": "425-633-0119",
            "fax_number": "425-746-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIABOVA",
        "first_name": "KATERINA",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "MD00041397",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00041397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1119734",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.