NPIMap

Individual provider Active NPI

Rajasri Dharani Palepu, MD

  • Internal Medicine Physician
  • Mukilteo, WA
National Provider Identifier
1568644607
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60022490 Issued in WA
Practice address
4112 Harbour Pointe Blvd SW
Mukilteo, WA 98275-5457
Phone
(425) 347-6330
Fax
(425) 374-6335
NPI assigned
Nov 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD60022490 WA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD60022490 WA Primary

Addresses

Primary practice location

4112 Harbour Pointe Blvd SW
Mukilteo, WA 98275-5457

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rpalepu263493@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081020000369 WA Practitioner - Internal Medicine 5294893269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60022490WAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Snohomish County CurrentSince Aug 26, 2011 Accepting new patients
Providence Health & Services- Washington CurrentSince Oct 1, 2016 Accepting new patients
Providence Health & Services - Washington CurrentSince Oct 1, 2016 Accepting new patients
Community Health Center of Snohomish County CurrentSince Aug 26, 2011 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

8609 Evergreen Way
Everett, WA 98208
Phone (425) 551-6200

1019 112th St SW
Everett, WA 98204
Phone (425) 551-6001

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

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

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

Organizations & group practices 6

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 12

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": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1568644607",
    "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": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 HARBOUR POINTE BLVD SW",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755457",
            "telephone_number": "425-347-6330",
            "fax_number": "425-374-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALEPU",
        "first_name": "RAJASRI",
        "middle_name": "DHARANI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD60022490",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60022490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpalepu263493@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4112 Harbour Pointe Blvd SW",
            "city": "Mukilteo",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982755457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

Verify at the official NPI Registry.