Individual provider Active NPI

Manasa Sudheendra, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Seattle, WA
National Provider Identifier
1609494186
Registry record updated Jul 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
61675833 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-0001
Phone
(206) 543-2340
NPI assigned
Jul 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 61675833 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-0001

Mailing address

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 543-2340

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
I20250617001331 WA Order and Referring Only - NeurologyPractitioner - Neurology 8820509821

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61675833WAMDNeurology with Special Qualifications in Child Neurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752364800000",
    "number": "1609494186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-543-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-543-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDHEENDRA",
        "first_name": "MANASA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2025-07-13",
        "certification_date": "2025-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "WA",
            "license": "61675833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.