Organization Active NPI

Allcare Medical Clinic Inc.

  • General Practice Physician
  • Renton, WA
National Provider Identifier
1720140619
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ALLCARE MEDICAL CLINIC INC.
Practice address
148 Park Ave N
Renton, WA 98057-5719
Phone
(425) 255-0055
Fax
(425) 255-9501
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Authorized official

Name
Dr. Dhiren N. Ajudia, MDNPI 1043235872
Title
President
Phone
(425) 255-0055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X WA Primary

Addresses

Primary practice location

148 Park Ave N
Renton, WA 98057-5719

Mailing address

148 Park Ave N
Renton, WA 98057-5719
Phone (425) 255-0055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080925000380 WA Part B Supplier - Clinic/Group Practice 2163599663 Receives reassigned benefits from 3 practitioners
Practice locations: Renton, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0630833Allcare Medical Clinic148 Park Ave North, Renton, WA 98057Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory

Locations

148 Park Ave N
Renton, WA 98057
Phone (425) 255-0055

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1720140619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 PARK AVE N",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575719",
            "telephone_number": "425-255-0055",
            "fax_number": "425-255-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 PARK AVE N",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575719",
            "telephone_number": "425-255-0055",
            "fax_number": "425-255-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLCARE MEDICAL CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "AJUDIA",
        "authorized_official_first_name": "DHIREN",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-255-0055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.