Individual provider Active NPI

Sonam Ravindra Kiwalkar, MD

  • Rheumatology Physician
  • Vancouver, WA
National Provider Identifier
1609215987
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD61065748 Issued in WA
Practice address
700 NE 87TH Ave Ste 330
Vancouver, WA 98664-4896
Phone
(360) 882-2778
Fax
(360) 604-1730
NPI assigned
Jun 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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 MD61065748 WA
Internal Medicine Physician 207R00000X MD194449 OR
Rheumatology Physician 207RR0500X MD194449 OR
Rheumatology Physician 207RR0500X MD61065748 WA Primary

Addresses

Primary practice location

700 NE 87TH Ave Ste 330
Vancouver, WA 98664-4896

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-4300

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-4300

Other identifiers 1

IdentifierTypeStateIssuer
2041321MedicaidWA

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
I20200820002129 WA Practitioner - Rheumatology 0042592552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

33501 1St Way S
Federal Way, WA 98003-6208
Phone (253) 838-2400

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD194449ORMDRheumatology Physician
MD61065748WAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Aug 31, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Mar 1, 2024 Accepting new patients
The Vancouver Clinic Inc PS Internal Medicine CurrentSince Oct 19, 2020 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Aug 31, 2020 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Mar 1, 2024 Accepting new patients

Locations

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

700 NE 87th Ave
Ste 330
Vancouver, WA 98664

Interoperability endpoints

  • Direct secure messaging: skiwalkar3183582@oc.providencedirect.org
  • Direct secure messaging: skiwalkar16767@tvc-direct.org

Organizations & group practices 7

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": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1609215987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-4300",
            "fax_number": "503-494-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE STE 330",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-4300",
            "fax_number": "503-494-4323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIWALKAR",
        "first_name": "SONAM",
        "middle_name": "RAVINDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61065748",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD194449",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OR",
            "license": "MD194449",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WA",
            "license": "MD61065748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2041321",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.