Active NPI
Sumathy T Pathy, M.D.
- Family Medicine Physician
- Bellevue, WA
National Provider Identifier
1346273158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00042001
- Practice address
- 11420 NE 20TH St Ste a
Bellevue, WA 98004-3007 - Phone
- (452) 688-5777
- Fax
- (425) 369-1435
- NPI assigned
- Jul 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00042001 | WA | Primary |
Addresses
Primary practice location
11420 NE 20TH St Ste a
Bellevue, WA 98004-3007
Mailing address
11420 Ne20Th Street
Bellevue, WA 98004-1501
Phone (425) 688-5470
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1117753 | Medicaid | WA | |
| MD00042001 | Other | WA | MD LICENSE |
Other names 1
- Sumathy Thiyagarajah
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
11420 NE 20TH St
Suite a
Bellevue, WA 98004-3007
Phone (425) 646-7800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00042001 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Medicine Center, PLLC | Family Medicine | Current | Accepting new patients |
| Overlake Medical Clinics LLC | Past | Accepting new patients | |
| Fort Wayne Medical Education Program | Family Medicine | Past | Accepting new patients |
| Overlake Medical Clinics, LLC | Past | Accepting new patients |
Locations
11420 NE 20th St
#A
Bellevue, WA 98004
Phone (425) 646-7800
1515 116th Ave NE
Ste 107
Bellevue, WA 98004
Phone (425) 646-7800
Interoperability endpoints
- https://api.platform.athenahealth.com/15476/brand/1/csg/1/fhir/r4
- sumathy.pathy.1@15476.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Bellevue, WA
- NPI 1265650261
-
- Specialist
- Bellevue, WA
- NPI 1871745703
-
- Specialist
- Bellevue, WA
- NPI 1801828421
-
- Family Medicine Physician
- Fort Wayne, IN
- NPI 1184635153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1346273158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11420 NE20TH STREET",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980041501",
"telephone_number": "425-688-5470",
"fax_number": "425-688-5605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11420 NE 20TH ST STE A",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980043007",
"telephone_number": "452-688-5777",
"fax_number": "425-369-1435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATHY",
"first_name": "SUMATHY",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-08",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00042001",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1117753",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD LICENSE",
"identifier": "MD00042001",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUMATHY",
"last_name": "THIYAGARAJAH",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.