Active NPI
Rotsna Pradhan, M.D.
- Psychiatry Physician
- Spokane, WA
National Provider Identifier
1497945489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD60688873
- Practice address
- 105 W 8TH Ave
Suite 450E
Spokane, WA 99204-2302 - Phone
- (509) 474-6920
- NPI assigned
- Jul 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD13746 | RI | |
| Psychiatry Physician | 2084P0800X | MD60688873 | WA | Primary |
Addresses
Primary practice location
105 W 8TH Ave
Suite 450E
Spokane, WA 99204-2302
Mailing address
PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RP85920 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 30, 2023 through Aug 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD13746 | RI | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479340800000",
"number": "1497945489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 421",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990190421",
"telephone_number": "866-747-2455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 W 8TH AVE",
"address_2": "SUITE 450E",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042302",
"telephone_number": "509-474-6920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRADHAN",
"first_name": "ROTSNA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-26",
"last_updated": "2016-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "RI",
"license": "MD13746",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "MD60688873",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RP85920",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.