Individual provider Active NPI

Ashutosh Kumar Mahajan, MD

  • Nephrology Physician
  • Spokane, WA
National Provider Identifier
1932140183
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD61367747 Issued in WA
Practice address
105 W 8TH Ave Ste 7010
Spokane, WA 99204-2312
Phone
(509) 474-6560
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M6269 TX
Nephrology Physician 207RN0300X M6269 TX
Nephrology Physician 207RN0300X MD61367747 WA Primary

Addresses

Primary practice location

105 W 8TH Ave Ste 7010
Spokane, WA 99204-2312

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other identifiers 2

IdentifierTypeStateIssuer
P00755700OtherTXMEDICARE RAILROAD
203772301MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amahajan27638@direct.sw.org Direct

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
I20230510002388 WA Practitioner - Nephrology 6507896776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

105 W 8TH Ave
Suite 7010
Spokane, WA 99204-2312
Phone (509) 474-6560

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Jun 1, 2023 Accepting new patients
Providence Health & Services Washington Internal Medicine CurrentSince Jun 1, 2023 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

105 W 8th Ave
Ste X
Spokane, WA 99204

105 W 8th Ave
Ste 7010
Spokane, WA 99204
Phone (509) 353-3901

Interoperability endpoints

  • Direct secure messaging: amahajan27638@direct.sw.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 4

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1932140183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 8TH AVE STE 7010",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042312",
            "telephone_number": "509-474-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAJAN",
        "first_name": "ASHUTOSH",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M6269",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "M6269",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD61367747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00755700",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203772301",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amahajan27638@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1700 University Dr E",
            "city": "College Station",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778402661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.