Jatinder Singh Banipal, MD
Individual provider Active NPI Internal Medicine Physician · Centralia, WA
NPI 1609300029 · NPPES record last updated Apr 15, 2021
Key facts
- NPI
- 1609300029
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD61086045 (WA)
- Practice address
- 914 S Scheuber Rd
Centralia, WA 98531-9027 - Phone
- (360) 827-8811
- NPI assigned
- Apr 12, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Providence Health and Services Washington
Practice addresses (Care Compare)
914 S Scheuber Rd
Centralia, WA 98531-9027
Phone (360) 736-2803
Hospital & facility affiliations
- Providence Centralia Hospital
- Providence St Peter Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201002001149 | WA | Practitioner - Internal Medicine |
1658644901 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61086045 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Washington | Current |
Accepting new patients | |
| Providence Health & Services Washington | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services Washington | Current |
Accepting new patients | |
| Providence Health & Services Washington | Current |
Accepting new patients | |
| Providence Health & Services Washington | Current |
Accepting new patients | |
| Providence Health & Services Washington | Current |
Accepting new patients | |
| Providence Health & Services Washington | Past | Accepting new patients |
Locations
914 S Scheuber Rd
Centralia, WA 98531
Phone (360) 330-8516
413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480
1018 Capitol Way S
Ste 300
Olympia, WA 98501
Phone (360) 486-6508
525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550
Interoperability endpoints
- jbanipal1368644@wm.providencedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | MD61086045 | WA | Yes |
Addresses
Primary practice location
914 S Scheuber Rd
Centralia, WA 98531-9027
Mailing address
PO Box 3360
Portland, OR 97208-3360
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jbanipal1368644@wm.providencedirect.org | Direct |
Other providers in Centralia, WA
- Bethanie Anne Baker
- Jordan Caila Baker
- Lindsay Baker
- Susan Baker
- Sarah Marie Balbuena
- Annie Barber
- Kimberlee Dawn Barge
- Berkley Barnum
- George Barr
- Crystal Marie Barton
All providers in Centralia, WA · Internal Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.