Individual provider Active NPI

Ravinder Singh Nijjar, MD

  • Family Medicine Physician
  • Covington, WA
National Provider Identifier
1790766350
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00040319 Issued in WA
Practice address
27500 168TH PL SE
Covington, WA 98042-5563
Phone
(253) 395-2006
Fax
(253) 395-1977
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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 MD00040319 WA Primary

Addresses

Primary practice location

27500 168TH PL SE
Covington, WA 98042-5563

Mailing address

PO Box 34876
Seattle, WA 98124-1876
Phone (425) 656-5412

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
I20050106000733 WA Practitioner - Family Practice 3375591316 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00040319WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Co Public Hospital District 3 CurrentSince Apr 1, 2024 Accepting new patients
Grant County Public Hospital District No. 3 Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Valley Medical Group-Renton Family Medicine CurrentSince May 15, 2010 Accepting new patients
Public Hospital District 1 of King County Past Accepting new patients
Bourget Health Services Inc Past Accepting new patients

Locations

27500 168th Pl SE
Covington, WA 98042
Phone (425) 690-3430

16850 SE 272nd St
Covington, WA 98042
Phone (253) 395-1960

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

200 Nat Washington Way
Ephrata, WA 98823
Phone (509) 754-3330

220 Nat Washington Way
Ephrata, WA 98823
Phone (509) 754-3330

24920 104th Ave SE
Kent, WA 98030
Phone (253) 395-1985

7203 129th Ave SE
#100
Newcastle, WA 98056
Phone (425) 656-5406

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

14410 SE Petrovitsky Rd
Ste 104
Renton, WA 98058
Phone (425) 656-4242

3915 Talbot Rd S
Ste 401
Renton, WA 98055
Phone (425) 656-4224

4033 Talbot Rd S
Ste 570
Renton, WA 98055
Phone (425) 656-5400

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1790766350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34876",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241876",
            "telephone_number": "425-656-5412",
            "fax_number": "425-656-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27500 168TH PL SE",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980425563",
            "telephone_number": "253-395-2006",
            "fax_number": "253-395-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIJJAR",
        "first_name": "RAVINDER",
        "middle_name": "SINGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00040319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, WA

Sources for this page

Verify at the official NPI Registry.