Individual provider Active NPI

Raveena Padda

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1336817253
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367
Phone
(206) 616-4001
NPI assigned
Sep 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-2400 ID
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367

Mailing address

4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367

Other practice location 1

700 W Ironwood Dr Ste 350
Coeur D Alene, ID 83814-4487
Phone (208) 625-5250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221219001151 ID Practitioner - Physician Assistant 2062881865 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

1055 Riverside Ave
Orofino, ID 83544-9029
Phone (208) 476-5777

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Hospital & facility affiliations

  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-2400IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. CurrentSince Dec 7, 2022 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Incyte Pathology, PLLC Current Accepting new patients
Kootenai Health, Inc. CurrentSince Dec 7, 2022 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. Physician Assistant Past Accepting new patients

Locations

6640 Kaniksu St
Bonners Ferry, ID 83805
Phone (208) 267-3141

700 W Ironwood Dr
Ste 350
Coeur D Alene, ID 83814
Phone (208) 625-5222

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

701 Lewiston St
Cottonwood, ID 83522
Phone (208) 962-3251

740 McKinley Ave
Kellogg, ID 83837
Phone (208) 783-1267

338 6th St
Lewiston, ID 83501
Phone (208) 746-3320

213 N Main St
Moscow, ID 83843
Phone (208) 882-2932

427 12th St
Plummer, ID 83851
Phone (208) 686-5081

1300 E Mullan Ave
Ste 900
Post Falls, ID 83854
Phone (208) 625-5530

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

600 N Cecil Rd
Post Falls, ID 83854
Phone (208) 262-2800

229 S 7th St
St Maries, ID 83861
Phone (208) 245-2591

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1336817253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367",
            "telephone_number": "206-616-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 W Ironwood Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838144487",
            "country_code": "US",
            "telephone_number": "208-625-5250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADDA",
        "first_name": "RAVEENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2400",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.