Individual provider Active NPI

Pulla Raghuram Reddy, MD

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Silverdale, WA
National Provider Identifier
1437167962
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
MD00044672 Issued in WA
Practice address
1950 NW Myhre Rd FL 3
Silverdale, WA 98383-7662
Phone
(564) 240-4200
Fax
(564) 240-4299
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X MD26229 OR
Cardiovascular Disease Physician 207RC0000X MD26229 OR
Cardiovascular Disease Physician 207RC0000X MD00044672 WA
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X MD00044672 WA Primary

Addresses

Primary practice location

1950 NW Myhre Rd FL 3
Silverdale, WA 98383-7662

Mailing address

1950 NW Myhre Rd FL 3
Silverdale, WA 98383-7662
Phone (564) 240-4200

Other practice location 1

501 N Graham St., Suite 200
Portland, OR 97227
Phone (503) 413-7162

Other identifiers 2

IdentifierTypeStateIssuer
023274MedicaidOR
1091740MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address preddy850747@fhsce.catholichealth.net Direct Franciscan Medical Group

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
I20050811000678 WA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Advanced Heart Failure and Transplant Cardiology 3870577497 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-6600

1950 NW Myhre Rd
Silverdale, WA 98383-7662
Phone (560) 240-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Internal Medicine CurrentSince Jun 24, 2024 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince May 28, 2019 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Cardiovascular Disease CurrentSince Jul 22, 2024 Accepting new patients
Virginia Mason Medical Center Cardiovascular Disease CurrentSince Jul 22, 2024 Accepting new patients
Providence Health & Services Washington CurrentSince Feb 1, 2024 Accepting new patients
Legacy Salmon Creek Hospital Current Accepting new patients
Franciscan Medical Group PastSince Sep 29, 2024 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

501 N Graham St
Ste 200
Portland, OR 97227
Phone (503) 413-4488

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1040 NW 22nd Ave
Ste 168
Portland, OR 97210
Phone (503) 413-7022

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

19250 SW 65th Ave
Tualatin, OR 97062
Phone (503) 691-6582

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

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

500 Lilly Rd NE
Ste 100
Olympia, WA 98506
Phone (360) 413-8525

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

1950 NW Myhre Rd
Silverdale, WA 98383
Phone (560) 240-4000

1950 NW Myhre Rd
Fl 3
Silverdale, WA 98383
Phone (564) 240-4200

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

2121 NE 139th St
Ste 360
Vancouver, WA 98686
Phone (360) 213-0085

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Interoperability endpoints

  • Direct secure messaging: preddy14399@direct.lhs.org

Organizations & group practices 9

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 6

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1437167962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 NW MYHRE RD FL 3",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837662",
            "telephone_number": "564-240-4200",
            "fax_number": "564-240-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 NW MYHRE RD FL 3",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837662",
            "telephone_number": "564-240-4200",
            "fax_number": "564-240-4299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 N Graham St., Suite 200",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97227",
            "country_code": "US",
            "telephone_number": "503-413-7162",
            "fax_number": "503-413-4711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "PULLA",
        "middle_name": "RAGHURAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "OR",
            "license": "MD26229",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD26229",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00044672",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "WA",
            "license": "MD00044672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023274",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1091740",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "preddy850747@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1950 NW Myhre Rd Fl 3",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983837662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.