NPIMap

Individual provider Active NPI

Salochna Khetpal

  • Family Medicine Physician
  • Puyallup, WA
National Provider Identifier
1659726271
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60961875 Issued in WA
Practice address
15214 Canyon Rd E Ste 100
Puyallup, WA 98375-7457
Phone
(253) 539-4200
NPI assigned
May 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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 MD60961875 WA Primary

Addresses

Primary practice location

15214 Canyon Rd E Ste 100
Puyallup, WA 98375-7457

Mailing address

15214 Canyon Rd E Ste 100
Puyallup, WA 98375-7457
Phone (253) 539-4200

Other practice location 1

300 E 6th St
3
Texarkana, AR 71854-5207
Phone (870) 779-6000

Other identifiers 1

IdentifierTypeStateIssuer
2143622MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skhetpal528474@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191206002480 WA Practitioner - Family Practice 4082906706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

15214 Canyon Rd E
Suite 100
Puyallup, WA 98375-7472
Phone (253) 539-4200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Family Medicine CurrentSince Oct 7, 2019 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Family Medicine Past Accepting new patients

Locations

15214 Canyon Rd E
Ste 100
Puyallup, WA 98375
Phone (253) 539-4200

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: skhetpal528474@fhsce.catholichealth.net

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1659726271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15214 CANYON RD E STE 100",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983757457",
            "telephone_number": "253-539-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15214 CANYON RD E STE 100",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983757457",
            "telephone_number": "253-539-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 E 6th St",
            "address_2": "3",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "AR",
            "postal_code": "718545207",
            "country_code": "US",
            "telephone_number": "870-779-6000",
            "fax_number": "870-779-6093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHETPAL",
        "first_name": "SALOCHNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-02",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60961875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2143622",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skhetpal528474@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "15214 Canyon Rd E Ste 100",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983757457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.