Individual provider Active NPI

Baburaj Thankappan, M.D

  • Neurology Physician
  • Renton, WA
National Provider Identifier
1770752248
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD60118975 Issued in WA
Practice address
400 S 43Rd St
Renton, WA 98055-5714
Phone
(425) 690-3585
Fax
(425) 690-9585
NPI assigned
Feb 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A102993 CA
Neurology Physician 2084N0400X MD60118975 WA Primary
Neurology Physician 2084N0400X 4301083145 MI

Addresses

Primary practice location

400 S 43Rd St
Renton, WA 98055-5714

Mailing address

3600 Lind Ave SW Ste 100
Renton, WA 98057-4970
Phone (425) 690-2715

Other identifiers 1

IdentifierTypeStateIssuer
2022266MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bthankappan27823@direct.valleymed.org Direct
FHIR URL https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/ Other

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121031000602 WA Practitioner - Neurology 4880756709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

16850 SE 272ND St
Covington, WA 98042-4931

400 S 43Rd St
Renton, WA 98055-5714
Phone (425) 228-3450

Hospital & facility affiliations

  • Valley Medical Center Hospital, Renton, WA, CCN 500088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A102993CAMDNeurology Physician
MD60118975WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Neurology CurrentSince Oct 1, 2012 Accepting new patients
Public Hospital District #1 of King County Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

3600 Lind Ave SW
Ste 100
Renton, WA 98057

3915 Talbot Rd S
Ste 104
Renton, WA 98055
Phone (425) 656-5566

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

Interoperability endpoints

  • Direct secure messaging: bthankappan27823@direct.valleymed.org

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.

Hospital & facility affiliations 2

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": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1770752248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW STE 100",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574970",
            "telephone_number": "425-690-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-690-3585",
            "fax_number": "425-690-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANKAPPAN",
        "first_name": "BABURAJ",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-28",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A102993",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD60118975",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301083145",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2022266",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bthankappan27823@direct.valleymed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bthankappan27823@direct.valleymed.org",
            "address_1": "400 S 43rd St",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "400 S 43rd St",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.