NPIMap

Individual provider Active NPI

Ranu Choudhary, MD

  • Internal Medicine Physician
  • Kent, WA
National Provider Identifier
1386664183
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
37861 Issued in WA
Practice address
24604 104TH Ave SE
Ste 202
Kent, WA 98030-5385
Phone
(253) 859-8371
Fax
(253) 859-9593
NPI assigned
Jul 21, 2006
Last updated
Oct 1, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37861 WA Primary

Addresses

Primary practice location

24604 104TH Ave SE
Ste 202
Kent, WA 98030-5385

Mailing address

24604 104TH Ave SE
#202
Kent, WA 98030-4965
Phone (253) 859-8371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031110000266 WA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 6103739834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

24604 104TH Ave SE
Suite 202
Kent, WA 98030-5385
Phone (253) 859-8371

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37861WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City South Dermatology PLLC CurrentSince Nov 11, 2020 Accepting new patients
104TH Avenue Medical Clinic Incorporated Internal Medicine CurrentSince Apr 28, 2008 Accepting new patients

Locations

24604 104th Ave SE
Ste 202
Kent, WA 98030
Phone (253) 398-7000

Interoperability endpoints

  • Direct secure messaging: rchoudhary109832@direct.multicare.org

Organizations & group practices 3

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 10

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1386664183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24604 104TH AVE SE",
            "address_2": "#202",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980304965",
            "telephone_number": "253-859-8371",
            "fax_number": "253-859-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24604 104TH AVE SE",
            "address_2": "STE 202",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305385",
            "telephone_number": "253-859-8371",
            "fax_number": "253-859-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUDHARY",
        "first_name": "RANU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "37861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

Verify at the official NPI Registry.