Individual provider Active NPI

Samantha Auxilio Viramontes, MD

  • Family Medicine Physician
  • Renton, WA
National Provider Identifier
1639792112
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61339197 Issued in WA
Practice address
3901 NE 4TH St Ste 105
Renton, WA 98056-4100
Phone
(425) 690-3410
Fax
(425) 690-9410
NPI assigned
May 19, 2020
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61339197 WA Primary

Addresses

Primary practice location

3901 NE 4TH St Ste 105
Renton, WA 98056-4100

Mailing address

3901 NE 4TH St Ste 105
Renton, WA 98056-4100
Phone (425) 690-3410

Other practice location 1

940 Northgate Dr
Richland, WA 99352-3505
Phone (509) 942-2516

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
I20230818002607 WA Practitioner - Family Practice 0840613279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

3901 NE 4TH St
Suite 105
Renton, WA 98056-4100
Phone (425) 656-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61339197WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Public Hospital District #1 of King County Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

3600 Lind Ave SW
Ste 100
Renton, WA 98057

3901 NE 4th St
Ste 105
Renton, WA 98056
Phone (425) 656-5377

Interoperability endpoints

  • Direct secure messaging: sviramontes109221@direct.valleymed.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1639792112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 NE 4TH ST STE 105",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980564100",
            "telephone_number": "425-690-3410",
            "fax_number": "425-690-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 NE 4TH ST STE 105",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980564100",
            "telephone_number": "425-690-3410",
            "fax_number": "425-690-9410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 Northgate Dr",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523505",
            "country_code": "US",
            "telephone_number": "509-942-2516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIRAMONTES",
        "first_name": "SAMANTHA",
        "middle_name": "AUXILIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61339197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.