Miranda McIntyre Raiche, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00046640 Issued in WA

Practice address

529 Jasmine St
Omak, WA 98841-9589

Phone

(509) 826-1600

Fax

(509) 826-3633

NPI assigned

Jun 28, 2006

Last updated

Jul 6, 2017By the provider in NPPES

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

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

Specialty

Family Practice

Education

Hahnemann University College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

600 Stewart Medical Group, P.C.Group PAC ID 6608260534, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 600 Stewart Medical Group, P.C.

  • Primary Care Clinic/Center
  • Seattle, WA
  • NPI 1487317954
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499299200000",
    "number": "1275560781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 COMMERCIAL ST",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988261316",
            "telephone_number": "509-548-3431",
            "fax_number": "509-548-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 JASMINE ST",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419589",
            "telephone_number": "509-826-1600",
            "fax_number": "509-826-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAICHE",
        "first_name": "MIRANDA",
        "middle_name": "MCINTYRE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2017-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00046640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0211040",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8457434",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terri Lynne Quezada
• Dean R Quigley, MD
• Shellie Ann Rabidou, PA-C
• Corina Marie Radford
• Gregory Rahn
• Carole Anne Raspaolo, LMP, BSNHS
• Floral Read, CPC
• Jessica Della Ready, ARNP, CNM
• Carlie Reddington
• Tara Reed

• Family Medicine Physician in Omak, WA
• Providers in Omak, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.