Individual provider Active NPI

Mandeep Kaur Walia, MD

  • Internal Medicine Physician
  • Renton, WA
National Provider Identifier
1285888206
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60548677 Issued in WA
Practice address
400 S 43Rd St
Renton, WA 98055-5714
Phone
(425) 228-3440
NPI assigned
Nov 5, 2008
Last updated
Jan 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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 MD60548677 WA Primary
Hospitalist Physician 208M00000X MD60548677 WA

Addresses

Primary practice location

400 S 43Rd St
Renton, WA 98055-5714

Mailing address

PO Box 34876
Seattle, WA 98124-1876
Phone (425) 656-5412

Other identifiers 1

IdentifierTypeStateIssuer
2047379MedicaidWA

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
I20160615000289 WA Practitioner - Internal MedicinePractitioner - Hospitalist 3173796497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

16850 SE 272ND St
Covington, WA 98042-4931

400 S 43Rd St
Renton, WA 98055-5714
Phone (425) 228-3450

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60548677WAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Internal Medicine CurrentSince Feb 1, 2017 Accepting new patients
Public Hospital District No 4, King County Wa Internal Medicine Past Accepting new patients
Middle Tennessee Hospitalist, PLC Internal Medicine Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

4011 Talbot Rd S
Ste 460
Renton, WA 98055
Phone (425) 251-5110

4011 Talbot Rd S
Ste 500
Renton, WA 98055
Phone (425) 251-5110

Interoperability endpoints

  • Direct secure messaging: mwalia1062401@wm.providencedirect.org
  • Direct secure messaging: mwalia55680@direct.valleymed.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1285888206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34876",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241876",
            "telephone_number": "425-656-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-228-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALIA",
        "first_name": "MANDEEP",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60548677",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD60548677",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2047379",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.