Individual provider Active NPI

Joanne Thambuswamy, MD

  • Family Medicine Physician
  • Everett, WA
National Provider Identifier
1295256071
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61039461 Issued in WA
Practice address
4705 31St Ave SE
Everett, WA 98203-1595
Phone
(425) 470-3030
Fax
(833) 428-7730
NPI assigned
Jun 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61039461 WA Primary

Addresses

Primary practice location

4705 31St Ave SE
Everett, WA 98203-1595

Mailing address

PO Box 2191
Everett, WA 98213-0191
Phone (425) 470-3030

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
I20200722003635 WA Practitioner - Family Practice 3274957212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Everett, WA 98203
Phone (425) 470-3030

4705 31St Ave SE
Everett, WA 98203-1595

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61039461WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC Family Medicine CurrentSince Aug 3, 2020 Accepting new patients
Inclusive Health PLLC CurrentSince Jan 1, 2025 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Aug 3, 2020 Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

3102 Hoyt Ave
#2191
Everett, WA 98201

8910 Vernon Rd
Lake Stevens, WA 98258
Phone (425) 397-1700

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: joanne.thambuswamy.1@32691.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1295256071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2191",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982130191",
            "telephone_number": "425-470-3030",
            "fax_number": "833-428-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 31ST AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982031595",
            "telephone_number": "425-470-3030",
            "fax_number": "833-428-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAMBUSWAMY",
        "first_name": "JOANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61039461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.