NPIMap

Organization Active NPI

Advanced Diabetes and Endocrine Care

  • Endocrinology, Diabetes & Metabolism Physician
  • Federal Way, WA
National Provider Identifier
1518375880
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD00032808 Issued in WA
Legal business name
ADVANCED DIABETES AND ENDOCRINE CARE
Practice address
700 S 320TH St
Suite D
Federal Way, WA 98003-4691
Phone
(253) 880-1029
Fax
(253) 322-6203
NPI assigned
Jul 30, 2014
Last updated
Nov 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Authorized official

Name
Dr. Shaista A Quddusi, M.D.NPI 1053340885
Title
President
Phone
(253) 880-1029

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD00032808 WA Primary

Addresses

Primary practice location

700 S 320TH St
Suite D
Federal Way, WA 98003-4691

Mailing address

700 S 320TH St
Suite D
Federal Way, WA 98003-4691
Phone (253) 880-1029

Other identifiers 1

IdentifierTypeStateIssuer
P00181501OtherWARAILROAD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1518375880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S 320TH ST",
            "address_2": "SUITE D",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034691",
            "telephone_number": "253-880-1029",
            "fax_number": "253-322-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S 320TH ST",
            "address_2": "SUITE D",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034691",
            "telephone_number": "253-880-1029",
            "fax_number": "253-322-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DIABETES AND ENDOCRINE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-30",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "QUDDUSI",
        "authorized_official_first_name": "SHAISTA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-880-1029",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WA",
            "license": "MD00032808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00181501",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.