NPIMap

Individual provider Active NPI

Anish S Konde, M.D.

  • Hematology & Oncology Physician
  • Lacey, WA
National Provider Identifier
1417343971
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD61187142 Issued in WA
Practice address
4525 3Rd Ave SE Ste 200
Lacey, WA 98503-1010
Phone
(360) 754-3934
Fax
(360) 943-8023
NPI assigned
Apr 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD61187142 WA
Hematology & Oncology Physician 207RH0003X MD61187142 WA Primary

Addresses

Primary practice location

4525 3Rd Ave SE Ste 200
Lacey, WA 98503-1010

Mailing address

4525 3Rd Ave SE Ste 200
Lacey, WA 98503-1010
Phone (360) 754-3934

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
I20211028002584 WA Practitioner - Hematology/Oncology 0648560631 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4525 3Rd Ave SE
Suite 200
Lacey, WA 98503-1010
Phone (360) 754-3934

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61187142WAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Nov 1, 2021 Accepting new patients
Providence Health & Services Washington Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
Providence Health & Services Washington Internal Medicine Current Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Providence Health & Services Washington CurrentSince Nov 1, 2021 Accepting new patients
Providence Health & Services Washington CurrentSince Nov 1, 2021 Accepting new patients
Providence Health & Services Washington CurrentSince Nov 1, 2021 Accepting new patients

Locations

914 S Scheuber Rd
Centralia, WA 98531
Phone (360) 330-8516

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

4525 3rd Ave SE
#200
Olympia, WA 98503
Phone (360) 533-6906

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

Interoperability endpoints

  • Direct secure messaging: akonde1782217@wm.providencedirect.org
  • Direct secure messaging: akonde563214@direct.hfhs.org

Organizations & group practices 7

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 9

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": "1428710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1417343971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 3RD AVE SE STE 200",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031010",
            "telephone_number": "360-754-3934",
            "fax_number": "360-943-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 3RD AVE SE STE 200",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031010",
            "telephone_number": "360-754-3934",
            "fax_number": "360-943-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDE",
        "first_name": "ANISH",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-11",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61187142",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WA",
            "license": "MD61187142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.