Individual provider Active NPI

Suman Pandey

  • Pediatrics Physician
  • Yakima, WA
National Provider Identifier
1396005682
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
60284531 Issued in WA
Practice address
2205 W Lincoln Ave
Yakima, WA 98902-2437
Phone
(509) 469-6305
Fax
(509) 575-3398
NPI assigned
May 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60284531 WA Primary

Addresses

Primary practice location

2205 W Lincoln Ave
Yakima, WA 98902-2437

Mailing address

2205 W Lincoln Ave
Yakima, WA 98902-2437
Phone (509) 469-6305

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spandey4893@yvfwc.direct-ci.com Direct

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
I20120830000498 WA Practitioner - Pediatric Medicine 1951558675 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60284531WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic Current Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Jul 5, 2012 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Jul 5, 2012 Accepting new patients

Locations

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

2205 W Lincoln Ave
Yakima, WA 98902
Phone (509) 469-6305

Interoperability endpoints

  • Direct secure messaging: spandey4893@yvfwc.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1396005682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 W LINCOLN AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022437",
            "telephone_number": "509-469-6305",
            "fax_number": "509-575-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 W LINCOLN AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022437",
            "telephone_number": "509-469-6305",
            "fax_number": "509-575-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDEY",
        "first_name": "SUMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-21",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "60284531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spandey4893@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2205 W Lincoln Ave",
            "city": "Yakima",
            "state": "WA",
            "country_code": "US",
            "postal_code": "989022437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.