Individual provider Active NPI

Purnima M. Patel, M.D.

  • Internal Medicine Physician
  • Everett, WA
National Provider Identifier
1487619060
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00046174 Issued in WA
Practice address
1330 Rockefeller Ave
Suite 210
Everett, WA 98201-1684
Phone
(425) 261-4940
Fax
(425) 261-4945
NPI assigned
Apr 18, 2006
Last updated
Jun 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 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 MD422343 PA
Internal Medicine Physician 207R00000X MD00046174 WA Primary

Addresses

Primary practice location

1330 Rockefeller Ave
Suite 210
Everett, WA 98201-1684

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 366-2983

Other identifiers 1

IdentifierTypeStateIssuer
8442253MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ppatel122056@wm.providencedirect.org 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
I20060906000069 WA Practitioner - Internal Medicine 8022921949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11603 State Ave
Suite G
Marysville, WA 98271-8465
Phone (360) 658-6800

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

1330 Rockefeller Ave
Everett, WA 98201-1676

4112 Harbour Pointe Blvd SW
Suite 100
Mukilteo, WA 98275-5457
Phone (425) 347-6330

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Jan 1, 2009 Accepting new patients
Providence Health & Services - Washington CurrentSince Jan 1, 2009 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

1330 Rockefeller Ave
Ste 210
Everett, WA 98201
Phone (425) 261-4940

900 Pacific Ave
Ste 501
Everett, WA 98201
Phone (425) 258-7550

11603 State Ave
Ste G
Marysville, WA 98271
Phone (360) 658-6800

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

Interoperability endpoints

  • Direct secure messaging: ppatel122056@wm.providencedirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1487619060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-366-2983",
            "fax_number": "425-317-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER AVE",
            "address_2": "SUITE 210",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011684",
            "telephone_number": "425-261-4940",
            "fax_number": "425-261-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PURNIMA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD422343",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00046174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8442253",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppatel122056@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1330 Rockefeller Ave",
            "address_2": "Suite 210",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.