Active NPI
Vilma E Quijada, MD
- Nephrology Physician
- Kent, WA
National Provider Identifier
1770511735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- MD00034300
- Practice address
- 24920 104TH Ave SE
Kent, WA 98030-6443 - Phone
- (425) 690-3544
- Fax
- (425) 690-9444
- NPI assigned
- Jun 29, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 20703 | DC | |
| Nephrology Physician | 207RN0300X | MD00034300 | WA | Primary |
Addresses
Primary practice location
24920 104TH Ave SE
Kent, WA 98030-6443
Mailing address
24920 104TH Ave SE
Kent, WA 98030-6443
Phone (425) 690-3544
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119381 | Other | WA | LABOR IND |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20703 | DC | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Kidney Centers | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Renton, WA
- NPI 1619209574
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Kent, WA
- NPI 1588378533
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643673600000",
"number": "1770511735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24920 104TH AVE SE",
"city": "KENT",
"state": "WA",
"postal_code": "980306443",
"telephone_number": "425-690-3544",
"fax_number": "425-690-9444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24920 104TH AVE SE",
"city": "KENT",
"state": "WA",
"postal_code": "980306443",
"telephone_number": "425-690-3544",
"fax_number": "425-690-9444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUIJADA",
"first_name": "VILMA",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2022-02-01",
"certification_date": "2022-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "DC",
"license": "20703",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "WA",
"license": "MD00034300",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR IND",
"identifier": "119381",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.