NPIMap

Individual provider Active NPI

Kaylesh K. Pandya, D.O.

  • Family Medicine Physician
  • Shelton, WA
National Provider Identifier
1477998599
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61475133 Issued in WA
Practice address
625 W Railroad Ave # 234
Shelton, WA 98584-3522
Phone
(360) 529-1234
Fax
(360) 284-2535
NPI assigned
May 2, 2013
Last updated
May 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X OS14868 FL
Family Medicine Physician 207Q00000X OS14868 FL
Family Medicine Physician 207Q00000X OP61475133 WA Primary

Addresses

Primary practice location

625 W Railroad Ave # 234
Shelton, WA 98584-3522

Mailing address

625 W Railroad Ave # 234
Shelton, WA 98584-3522
Phone (360) 529-1234

Other practice location 1

153 Johns Ct
Shelton, WA 98584-8225
Phone (360) 427-2575

Other practice location 2

2430 N 13th St
Shelton, WA 98584-1213
Phone (360) 426-1651

Other identifiers 1

IdentifierTypeStateIssuer
OP61475133OtherWAWASHINGTON OSTEOPATHIC PHYSICIAN LICENSE

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
I20231111000393 WA Practitioner - Family Practice 0941545057 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Medical Specialty GroupGroup PAC ID 2365838364, 56 clinicians

Practice addresses (Care Compare)

3020 S Union Ave
Tacoma, WA 98409-3317
Phone (253) 844-4327

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS14868FLMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rejuvenation Medical PLLC Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
Pacific Medical Specialty Group CurrentSince Sep 1, 2025 Accepting new patients
Post Acute Medical PLLC CurrentSince Jun 6, 2024 Accepting new patients
Platinum Peaks Healthcare PC CurrentSince Sep 10, 2025 Accepting new patients
Fir Lane Care LLC Past Accepting new patients
Bremerton Health, LLC Past Accepting new patients
Forest Ridge Health - Bremerton LLC Past Accepting new patients
Rincon Beach, LLC Past Accepting new patients
Fir Lane Health-Shelton,LLC Past Accepting new patients
Shelton SNF Operations, LLC Past Accepting new patients
Crestwood Convalescent - Port Angeles LLC Past Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

414 17th St SE
Auburn, WA 98002
Phone (253) 320-0748

2222 Meridian Ave E
Ste A
Edgewood, WA 98371
Phone (206) 407-4171

153 Johns Ct
Shelton, WA 98584
Phone (253) 476-5300

2430 N 13th St
Shelton, WA 98584
Phone (360) 426-1651

6025 N Assembly St
Spokane, WA 99205
Phone (509) 326-8282

3020 S Union Ave
Tacoma, WA 98409
Phone (253) 844-4327

6220 S Alaska St
Tacoma, WA 98408
Phone (253) 473-2273

917 Pacific Ave
Ste 600
Tacoma, WA 98402
Phone (253) 232-7495

12844 Military Rd S
Tukwila, WA 98168
Phone (206) 244-0180

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Shelton Health & Rehabilitation CenterShelton, WA, CCN 505507 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 31, 2023
Aug 31, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

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 2

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": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1477998599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W RAILROAD AVE # 234",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985843522",
            "telephone_number": "360-529-1234",
            "fax_number": "360-284-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W RAILROAD AVE # 234",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985843522",
            "telephone_number": "360-529-1234",
            "fax_number": "360-284-2535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 Johns Ct",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "WA",
            "postal_code": "985848225",
            "country_code": "US",
            "telephone_number": "360-427-2575",
            "fax_number": "360-427-2563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2430 N 13th St",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "WA",
            "postal_code": "985841213",
            "country_code": "US",
            "telephone_number": "360-426-1651",
            "fax_number": "360-358-8752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANDYA",
        "first_name": "KAYLESH",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-02",
        "last_updated": "2025-05-16",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "FL",
            "license": "OS14868",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS14868",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61475133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON OSTEOPATHIC PHYSICIAN LICENSE",
            "identifier": "OP61475133",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

Verify at the official NPI Registry.