Llewellyn Nayagam Packia Raj, MD

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

MD00040226 Issued in WA

Practice address

1750 112TH Ave NE Ste D258
Bellevue, WA 98004-3727

Phone

(425) 498-2272

Fax

(425) 498-2334

NPI assigned

May 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Specialty

Physical Medicine and RehabilitationAlso: Internal Medicine, Interventional Pain Management, Sports Medicine

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051

Merit-based Incentive Payment System (MIPS)

Final score

86.73 of 100Reported as apm

Quality

73.46

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lpackiaraj41222@ghc.direct-ci.net

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.

• Overlake Medical Clinics, LLC

  • Specialist
  • Bellevue, WA
  • NPI 1801828421
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Inpatient Consultants of California, Inc.

  dba IPC of Washington

  • Hospitalist Physician
  • Berkeley, CA
  • NPI 1487930541

  Internal Medicine, WA

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  dba Everett Medical Center

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1669619870
  NPD
• Overlake Medical Clinics LLC

  • Specialist
  • Bellevue, WA
  • NPI 1871745703
  NPD
• Inpatient Consultants of California, Inc

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1992189286
  NPD
• Issaquah Obstetrics and Gynecology PLLC

  • Obstetrics & Gynecology Physician
  • Issaquah, WA
  • NPI 1073581807
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1598971855
  Care Compare affiliation
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1861432726
  Care Compare affiliation

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1659339695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 112TH AVE NE STE D258",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043727",
            "telephone_number": "425-498-2272",
            "fax_number": "425-498-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKIA RAJ",
        "first_name": "LLEWELLYN",
        "middle_name": "NAYAGAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00040226",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD00040226",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WA",
            "license": "MD00040226",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "WA",
            "license": "MD00040226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659339695",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Vision Services, PLLC (Vision Plus Bellevue)
• Pacifica Behavioral Health
• Wendy Pacifici, LCSW
• Albert Dominick Pacifico II, M.D.
• Scott Alexander Packebush
• Nancy J Padden
• Patricia L Paddison, M.D.
• David P Padilla, PHARMD
• Reynor Ibrahim Padilla
• Gene Paek, M.D.

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.