Active NPI
Sudha Elangovan, M.D.
- Family Medicine Physician
- Bothell, WA
National Provider Identifier
1730154329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00046277
- Practice address
- 1909 214TH St SE
Suite 300
Bothell, WA 98021-4412 - Phone
- (425) 412-7200
- NPI assigned
- Feb 17, 2006
- Last updated
- Jul 20, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00046277 | WA | Primary |
Addresses
Primary practice location
1909 214TH St SE
Suite 300
Bothell, WA 98021-4412
Mailing address
1200 12TH Ave S
Pacific Medical Center, BLDG Quarters 5
Seattle, WA 98144-2712
Phone (206) 621-4316
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Kansas School of Medicine Wichita Medical Practice Assoc | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Wichita, KS
- NPI 1639143712
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342742400000",
"number": "1730154329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 12TH AVE S",
"address_2": "PACIFIC MEDICAL CENTER, BLDG QUARTERS 5",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981442712",
"telephone_number": "206-621-4316",
"fax_number": "206-621-4076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1909 214TH ST SE",
"address_2": "SUITE 300",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980214412",
"telephone_number": "425-412-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELANGOVAN",
"first_name": "SUDHA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-17",
"last_updated": "2012-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00046277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bothell, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.