Organization Active NPI

Dhirendra MD PLLC

  • Family Medicine Physician
  • Redmond, WA
National Provider Identifier
1376949248
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DHIRENDRA MD PLLC
Practice address
4018 166TH Ave NE
Redmond, WA 98052-5400
Phone
(224) 766-9400
NPI assigned
Nov 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Authorized official

Name
Dhirendra Kumar, MDNPI 1437326915
Title
MD/Owner
Phone
(224) 766-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4018 166TH Ave NE
Redmond, WA 98052-5400

Mailing address

4018 166TH Ave NE
Redmond, WA 98052-5400
Phone (224) 766-9400

Other identifiers 1

IdentifierTypeStateIssuer
MD60287313OtherWAWA MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150130000319 WA Part B Supplier - Clinic/Group Practice 7012231632 Receives reassigned benefits from 7 practitioners
Practice locations: Bellevue, WA; Des Moines, WA; Everett, WA; Kirkland, WA; Lynnwood, WA; Redmond, WA; Seattle, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1376949248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4018 166TH AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525400",
            "telephone_number": "224-766-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4018 166TH AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525400",
            "telephone_number": "224-766-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHIRENDRA MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-05",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "DHIRENDRA",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "224-766-9400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA MEDICAL LICENSE",
            "identifier": "MD60287313",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.