Individual provider Active NPI

Littu Thomas Skariah, MD

  • Family Medicine Physician
  • Centralia, WA
National Provider Identifier
1639308661
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60529478 Issued in WA
Practice address
1010 S Scheuber Rd Ste 3&4
PMG SW Wa Centralia Int Med
Centralia, WA 98531-8892
Phone
(360) 827-7966
Fax
(360) 827-7977
NPI assigned
Jul 12, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD163909 OR
Family Medicine Physician 207Q00000X MD60529478 WA Primary

Addresses

Primary practice location

1010 S Scheuber Rd Ste 3&4
PMG SW Wa Centralia Int Med
Centralia, WA 98531-8892

Mailing address

PO Box 3360
Portland, OR 97208-3360

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
I20150421001294 WA Practitioner - Family Practice 5092949073 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60529478WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Medical Center Specialty Physicians, LLC CurrentSince Feb 9, 2016 Accepting new patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince Apr 20, 2018 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Apr 20, 2018 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients

Locations

3920 Capital Mall Dr SW
Ste 200
Olympia, WA 98502
Phone (360) 459-7282

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1247356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1639308661",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S SCHEUBER RD STE 3&4",
            "address_2": "PMG SW WA CENTRALIA INT MED",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985318892",
            "telephone_number": "360-827-7966",
            "fax_number": "360-827-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKARIAH",
        "first_name": "LITTU",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-12",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD163909",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60529478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

Verify at the official NPI Registry.