Individual provider Active NPI

Soumya Choudhury, MD

  • Family Medicine Physician
  • Renton, WA
National Provider Identifier
1871117754
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61314173 Issued in WA
Practice address
3915 Talbot Rd S Ste 401
Renton, WA 98055-5738
Phone
(425) 690-3445
Fax
(425) 690-9445
NPI assigned
Jun 5, 2020
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X ML61066886 WA
Family Medicine Physician 207Q00000X MD61314173 WA Primary

Addresses

Primary practice location

3915 Talbot Rd S Ste 401
Renton, WA 98055-5738

Mailing address

3600 Lind Ave SW
Suite 100 Attn Credentialing
Renton, WA 98057
Phone (425) 690-2715

Other identifiers 1

IdentifierTypeStateIssuer
2158969MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address schoudhary79302@direct.valleymed.org
FHIR URL https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/ Other

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
I20231018001913 WA Practitioner - Family Practice 5991128266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth Univ School of Dentistry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1801 Lind Ave SW
Renton, WA 98057-3368
Phone (425) 227-3700

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics CurrentSince Oct 9, 2023 Accepting new patients
Pacmed Clinics CurrentSince Oct 9, 2023 Accepting new patients

Locations

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

1801 Lind Ave SW
Bldg D
Renton, WA 98057
Phone (425) 227-3700

601 S Carr Rd
Ste 100
Renton, WA 98055
Phone (425) 227-3700

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

Interoperability endpoints

  • Direct secure messaging: schoudhury3021506@wm.providencedirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1871117754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "SUITE 100 ATTN CREDENTIALING",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98057",
            "telephone_number": "425-690-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 TALBOT RD S STE 401",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555738",
            "telephone_number": "425-690-3445",
            "fax_number": "425-690-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUDHURY",
        "first_name": "SOUMYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "ML61066886",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61314173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2158969",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schoudhary79302@direct.valleymed.org",
            "affiliation": "N",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "schoudhary79302@direct.valleymed.org",
            "address_1": "3915 Talbot Rd S Ste 401",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555738",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3915 Talbot Rd S Ste 401",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.