Individual provider Active NPI

Promish Shrestha, MD

  • Hospitalist Physician
  • Youngstown, OH
National Provider Identifier
1366797524
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD60613593 Issued in WA
Practice address
500 Gypsy LN
Youngstown, OH 44504-1315
Phone
(425) 516-9577
NPI assigned
Jul 13, 2012
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2015-01582 NC
Internal Medicine Physician 207R00000X MD60613593 WA
Hospitalist Physician 208M00000X MD60613593 WA Primary

Addresses

Primary practice location

500 Gypsy LN
Youngstown, OH 44504-1315

Mailing address

500 Gypsy LN
Youngstown, OH 44504-1315
Phone (425) 516-9577

Other practice location 1

400 S 43rd St
Renton, WA 98055-5714
Phone (425) 228-3440 ext. 4322

Other identifiers 1

IdentifierTypeStateIssuer
2051082MedicaidWA

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
I20160122001301 WA Practitioner - HospitalistPractitioner - Internal Medicine 2365752052 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 424-4111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Dec 12, 2015 Accepting new patients
Valley Medical Group-Renton Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
South Sound Inpatient Physicians PLLC Hospitalist CurrentSince Dec 12, 2015 Accepting new patients
Cogent Healthcare of Washington, PC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

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

1415 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 416-5750

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

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

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

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

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": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1366797524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GYPSY LN",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041315",
            "telephone_number": "425-516-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GYPSY LN",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041315",
            "telephone_number": "425-516-9577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 S 43rd St",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980555714",
            "country_code": "US",
            "telephone_number": "425-228-3440 x4322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHRESTHA",
        "first_name": "PROMISH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-13",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2015-01582",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60613593",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD60613593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2051082",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.