Mandya Vishwanath, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

MD00026524 Issued in WA

Practice address

62 W 7TH Ave Ste 110
Spokane, WA 99204-2321

Phone

(509) 456-0262

Fax

(509) 462-5059

NPI assigned

Jul 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Providence Health & Services Washington

  • Cardiovascular Disease Physician
  • Spokane, WA
  • NPI 1881907715
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1851399703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 W 7TH AVE STE 110",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042321",
            "telephone_number": "509-456-0262",
            "fax_number": "509-462-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 W 7TH AVE STE 110",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042321",
            "telephone_number": "509-456-0262",
            "fax_number": "509-462-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISHWANATH",
        "first_name": "MANDYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "ID",
            "license": "M-9402",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD00026524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8116113",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "11316531",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8871137",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8877877",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvishwanath206569@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "500 W Broadway St Ste 320",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598024003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvishwanath206569@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "62 W 7th Ave",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992042321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cameron Vincent
• Thomas Marvin Vincent, PA-C
• Xenia Marija Vincent, LMT
• Yelena Vinnikova, CO60932973
• Viridis Wound Management PLLC
• Jason Visintainer
• Vision Arts Eyecare Center
• Visionworks, Inc.
• Julia Vladimirovna Vistorovskaya
• Yana Vistorovskaya

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.