Individual provider Active NPI

Nimali D Mendis, M.D.

  • Rheumatology Physician
  • Seattle, WA
National Provider Identifier
1952306979
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD00036002 Issued in WA
Practice address
1200 12TH Ave S
Seattle, WA 98144-2712
Phone
(206) 326-2400
NPI assigned
Jun 16, 2005
Last updated
Jun 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MD00036002 WA Primary

Addresses

Primary practice location

1200 12TH Ave S
Seattle, WA 98144-2712

Mailing address

1200 12TH Ave S
Seattle, WA 98144-2712
Phone (206) 326-2400

Other practice location 1

601 S Carr Rd Ste 100
Renton, WA 98055-5802
Phone (425) 227-3700

Other identifiers 1

IdentifierTypeStateIssuer
34579000MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nmendis1042507@wm.providencedirect.org Direct
Direct Messaging Address nmendis1042507@wm.providencedirect.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
I20090818000848 WA Practitioner - Rheumatology 8921067406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

10416 5TH Ave NE
Seattle, WA 98125-7402
Phone (206) 517-6700

1101 Madison St
Suite 301
Seattle, WA 98104-3599
Phone (206) 505-1300

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00036002WAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics CurrentSince Jul 13, 2009 Accepting new patients
Pacmed Clinics CurrentSince Jul 13, 2009 Accepting new patients
Milwaukee Rheumatology Center, SC Rheumatology PastSince Mar 1, 2002 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

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

Interoperability endpoints

  • Direct secure messaging: nmendis1042507@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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1952306979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712",
            "telephone_number": "206-326-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712",
            "telephone_number": "206-326-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 S Carr Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980555802",
            "country_code": "US",
            "telephone_number": "425-227-3700",
            "fax_number": "425-227-3115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDIS",
        "first_name": "NIMALI",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WA",
            "license": "MD00036002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34579000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmendis1042507@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1200 12th Ave S",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981442712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmendis1042507@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "601 S Carr Rd Ste 100",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.