Individual provider Active NPI

Poornima Krishnaiah, M.D.

  • Family Medicine Physician
  • Auburn, WA
National Provider Identifier
1497948467
Registry record updated Oct 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60114667 Issued in WA
Practice address
735 12TH St SE
Auburn, WA 98002-4400
Phone
(253) 876-7990
Fax
(253) 876-7991
NPI assigned
Aug 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60114667 WA Primary

Addresses

Primary practice location

735 12TH St SE
Auburn, WA 98002-4400

Mailing address

735 12 TH St SE
Auburn, WA 98002
Phone (253) 876-7990

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
I20110426000169 WA Practitioner - Family Practice 4587849187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1909 214TH St SE
Suite 110
Bothell, WA 98021-4412
Phone (425) 488-4988

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60114667WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Family Medicine CurrentSince Apr 11, 2011 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Public Hospital District No 2 Family Medicine CurrentSince Apr 15, 2019 Accepting new patients
King County Public Hospital District No 2 Family Medicine Current Accepting new patients
King County Public Hospital District No. 2 Family Medicine Current Accepting new patients
Multicare Health System Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Apr 15, 2019 Accepting new patients
Multicare Health System CurrentSince Apr 11, 2011 Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients

Locations

735 12th St SE
Auburn, WA 98002
Phone (253) 867-7990

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

8980 161st Ave NE
Ste 400
Redmond, WA 98052
Phone (425) 883-3404

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

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 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": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1497948467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 12 TH ST SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "98002",
            "telephone_number": "253-876-7990",
            "fax_number": "253-876-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 12TH ST SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980024400",
            "telephone_number": "253-876-7990",
            "fax_number": "253-876-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNAIAH",
        "first_name": "POORNIMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60114667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

Verify at the official NPI Registry.