Individual provider Active NPI

Surinder Kumar Singh, MD

  • Internal Medicine Physician
  • Puyallup, WA
National Provider Identifier
1437115789
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00044693 Issued in WA
Practice address
10217 125TH Street CT E
CT E 2ND FL
Puyallup, WA 98374-2761
Phone
(253) 864-4550
Fax
(253) 864-4558
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15612 PR
Internal Medicine Physician 207R00000X MD00044693 WA Primary
Internal Medicine Physician 207R00000X 5551 AK

Addresses

Primary practice location

10217 125TH Street CT E
CT E 2ND FL
Puyallup, WA 98374-2761

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (206) 764-3335

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
I20090311000667 WA Practitioner - General Practice 4587752506 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5551AKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers CurrentSince Jan 3, 2012 Accepting new patients
Sea Mar Community Health Centers Internal Medicine CurrentSince Jan 3, 2012 Accepting new patients
Sea Mar Community Health Centers Current Accepting new patients

Locations

10217 125th Street Ct E
Fl 2
Puyallup, WA 98374
Phone (253) 864-4550

7410 Delaware Ln
Vancouver, WA 98664
Phone (360) 566-4402

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1437115789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-3335",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10217 125TH STREET CT E",
            "address_2": "CT E 2ND FL",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742761",
            "telephone_number": "253-864-4550",
            "fax_number": "253-864-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINGH",
        "first_name": "SURINDER",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "15612",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00044693",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "5551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.