Individual provider Active NPI

Sunida Bintasan, M.D.

  • Psychiatry Physician
  • Federal Way, WA
National Provider Identifier
1902022775
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD00021407 Issued in WA
Practice address
500 S 336TH St Ste 213
Federal Way, WA 98003-6478
Phone
(206) 995-0727
Fax
(206) 325-5020
NPI assigned
Apr 18, 2007
Last updated
Mar 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD00021407 WA Primary
Psychosomatic Medicine Physician 2084P0015X 21407 WA

Addresses

Primary practice location

500 S 336TH St Ste 213
Federal Way, WA 98003-6478

Mailing address

1615 S Washington St
Seattle, WA 98144-2120
Phone (206) 228-5020

Other identifiers 1

IdentifierTypeStateIssuer
1422058MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21407WAMDPsychosomatic Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonspirit Washington Past Accepting new patients
Commonspirit Washington Past Accepting new patients
Commonspirit Washington Past Accepting new patients
Saint Clare Hospital Past Accepting new patients
Comprehensive Mental Health Center of Tacoma-Pierce County PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1902022775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 S WASHINGTON ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442120",
            "telephone_number": "206-228-5020",
            "fax_number": "206-325-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 336TH ST STE 213",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036478",
            "telephone_number": "206-995-0727",
            "fax_number": "206-325-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINTASAN",
        "first_name": "SUNIDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00021407",
            "primary": true
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "WA",
            "license": "21407",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1422058",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.