Individual provider Active NPI

Suraj Reddy Muddasani, MD

  • Dermatology Physician
  • Puyallup, WA
National Provider Identifier
1376129106
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD61657223 Issued in WA
Practice address
1703 S Meridian Ste 101
Puyallup, WA 98371-7590
Phone
(253) 446-3904
NPI assigned
Mar 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X MD61657223 WA Primary

Addresses

Primary practice location

1703 S Meridian Ste 101
Puyallup, WA 98371-7590

Mailing address

1703 S Meridian Ste 101
Puyallup, WA 98371-7590
Phone (253) 446-3904

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
I20250730002089 WA Practitioner - Dermatology 0840707188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Cincinnati College of Medicine and Surgery, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cascade Eye and Skin Centers PCGroup PAC ID 4486541554, 47 clinicians

Practice addresses (Care Compare)

1703 S Meridian
Suite 101
Puyallup, WA 98371-7590
Phone (253) 848-3000

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions234
Skin biopsy296

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Eye & Skin Centers PC Dermatology CurrentSince Sep 8, 2025 Accepting new patients
Cascade Eye & Skin Centers P.C. Dermatology CurrentSince Sep 8, 2025 Accepting new patients

Locations

205 10th St NE
Ste 119
Auburn, WA 98002
Phone (253) 939-7911

4907 Point Fosdick Dr
Ste E700
Gig Harbor, WA 98335

1703 S Meridian
Ste 101
Puyallup, WA 98371
Phone (253) 770-7708

5225 Cirque Dr W
University Place, WA 98467
Phone (253) 564-3365

Organizations & group practices 2

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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1376129106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-446-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-446-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDDASANI",
        "first_name": "SURAJ",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD61657223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.