Individual provider Active NPI

Tiffany M. Ludka-Gaulke, MD

  • Internal Medicine Physician
  • Spokane, WA
National Provider Identifier
1518115393
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60563033 Issued in WA
Practice address
9911 N Nevada St
Spokane, WA 99218-1298
Phone
(509) 626-9420
Fax
(509) 227-7070
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 53392 WI
Pediatrics Physician 208000000X MD60563033 WA
Pediatrics Physician 208000000X 53392 WI
Internal Medicine Physician 207R00000X MD60563033 WA Primary

Addresses

Primary practice location

9911 N Nevada St
Spokane, WA 99218-1298

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tludkagaulke540081@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
I20150814013940 WA Practitioner - Internal Medicine 0547419913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1200 E Columbia Ave
Colville, WA 99114-3354
Phone (509) 684-3701

9911 N Nevada St
Suite 200
Spokane, WA 99218-1298
Phone (509) 626-9420

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60563033WAMDPediatrics Physician
53392WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

9911 N Nevada St
Ste 200
Spokane, WA 99218
Phone (509) 626-9420

101 W 8th Ave
Ste 100
Spokane, WA 99204
Phone (509) 474-2880

9911 N Nevada St
Spokane, WA 99218
Phone (509) 326-4445

212 E Central Ave
Ste 440
Spokane, WA 99208
Phone (509) 252-1977

Interoperability endpoints

  • Direct secure messaging: tludkagaulke540081@wm.providencedirect.org

Organizations & group practices 2

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 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": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1518115393",
    "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": "9911 N NEVADA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181298",
            "telephone_number": "509-626-9420",
            "fax_number": "509-227-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDKA-GAULKE",
        "first_name": "TIFFANY",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "53392",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60563033",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "53392",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60563033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tludkagaulke540081@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9911 N Nevada St",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992181298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.