NPIMap

Organization Active NPI

Razan R Al-Kudsi MD

  • Nephrology Physician
  • Burien, WA
National Provider Identifier
1831110782
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD00028577 Issued in WA
Legal business name
RAZAN R AL-KUDSI MD
Practice address
16259 Sylvester Rd SW
Suite 401
Burien, WA 98166-3049
Phone
(206) 242-8837
NPI assigned
Jul 23, 2006
Last updated
May 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Authorized official

Name
Dr. Razan R Al Kudsi, MDNPI 1497790687
Title
Owner
Phone
(206) 242-8837

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD00028577 WA Primary

Addresses

Primary practice location

16259 Sylvester Rd SW
Suite 401
Burien, WA 98166-3049

Mailing address

16259 Sylvester Rd SW
#401
Burien, WA 98166-3049
Phone (206) 242-8837

Other identifiers 2

IdentifierTypeStateIssuer
110061080OtherWARR MEDICARE
1073238MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070321000068 WA Part B Supplier - Clinic/Group Practice 8224131735 Receives reassigned benefits from 1 practitioner
Practice locations: Burien, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1831110782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16259 SYLVESTER RD SW",
            "address_2": "#401",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663049",
            "telephone_number": "206-242-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16259 SYLVESTER RD SW",
            "address_2": "SUITE 401",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663049",
            "telephone_number": "206-242-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAZAN R AL-KUDSI MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "AL KUDSI",
        "authorized_official_first_name": "RAZAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-242-8837",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD00028577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110061080",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073238",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.