Ranmali Kalyani Walaliyadda, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-624 Issued in ID

Practice address

1448 E Center St
Suite E
Pocatello, ID 83201-4132

Phone

(208) 234-1300

Fax

(208) 234-1333

NPI assigned

Oct 16, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arthritis Specialty Center,IncGroup PAC ID 3274632807, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028
• Caribou Medical Center Hospital, Soda Springs, ID, CCN 131309
• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Merit-based Incentive Payment System (MIPS)

Final score

74.21 of 100Reported as group

Quality

82.55

Promoting interoperability

97

Improvement activities

40

Cost

33.97

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Arthritis Specialty Center,Inc

  • Specialist
  • Pocatello, ID
  • NPI 1801989454
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Caribou Medical Center, Inc

  dba Caribou Medical Center

  • Critical Access Hospital
  • Soda Springs, ID
  • NPI 1942970272
  Care Compare affiliation
• Eastern Idaho Health Services Inc

  dba Eastern Idaho Regional Medical Center

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• Pocatello Hospital LLC

  dba Portneuf Rehabilitation Center

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114
  Care Compare affiliation
• Pocatello Hospital LLC

  dba Portneuf Medical Center

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055
  Care Compare affiliation

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801976923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 E CENTER ST",
            "address_2": "SUITE E",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014132",
            "telephone_number": "208-234-1300",
            "fax_number": "208-234-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 E CENTER ST",
            "address_2": "SUITE E",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014132",
            "telephone_number": "208-234-1300",
            "fax_number": "208-234-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALALIYADDA",
        "first_name": "RANMALI",
        "middle_name": "KALYANI",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine F Waite, DPT
• Wal-Mart Stores, Inc (Vision Center 30-1995)
• Ananda Walaliyadda, M.D.
• Hemantha Naveen Walaliyadda, MD
• Praveen Anuradha Walaliyadda, MD
• Stephanie Theresa Walbridge, MS, PA-C
• Sean Paul Waldron, MSW
• Shayna Waldron, SLP
• Walgreen Co (Walgreens #06380)
• Bradley L Walker

• Physician Assistant in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• 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.