Mantavya Punj, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD61357479 Issued in WA

Practice address

9605 Sandifur Pkwy
Pasco, WA 99301-8028

Phone

(509) 942-3170

Fax

(509) 543-9795

NPI assigned

Jun 15, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

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

Specialty

Family PracticeAlso: Sleep Medicine

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tri-Cities Home Health Home health agency, Kennewick, WA, CCN 507010
• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
• Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpunj2908994@wm.providencedirect.org

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.

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Medicare reassignment Care Compare group NPD
• Kadlec Regional Medical Center

  • Rehabilitation Hospital Unit
  • Richland, WA
  • NPI 1790319580
  NPD

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

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation
• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  Care Compare affiliation
• Tri-Cities Home Health, LLC

  • Home Health Agency
  • Kennewick, WA
  • NPI 1679547244
  Care Compare affiliation

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

{
    "created_epoch": "1560556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1831759596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-946-4611",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9605 SANDIFUR PKWY",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018028",
            "telephone_number": "509-942-3170",
            "fax_number": "509-543-9795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 San Pablo Rd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322241865",
            "country_code": "US",
            "telephone_number": "904-953-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUNJ",
        "first_name": "MANTAVYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-15",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "WA",
            "license": "MD61357479",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "WA",
            "license": "MD61357479",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61357479",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "FL",
            "license": "ME154593",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN29309",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpunj604358@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Placido, LICSW
• Planned Parenthood of Greater Washington & North Idaho
• Planned Parenthood of Greater Washington and North Idaho
• Jennifer Lynn Powell, RN
• Jesse Mathew Powell
• Julissa Quintero
• Maythe Itzel Quintero
• Rebecka Rose Quiroz
• Jan Lorraine Rabe, R.N.
• Nemesio A Racsa, MD

• Family Medicine Physician in Pasco, WA
• Providers in Pasco, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.