NPIMap

Individual provider Active NPI

Pragathy Vutla, M.D.

  • Internal Medicine Physician
  • Tacoma, WA
National Provider Identifier
1952369795
Registry record updated May 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00045419 Issued in WA
Practice address
1717 S J St
Ms 01-36
Tacoma, WA 98405-4933
Phone
(253) 426-6363
NPI assigned
May 2, 2006
Last updated
May 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 226667 MA
Internal Medicine Physician 207R00000X MD00045419 WA Primary

Addresses

Primary practice location

1717 S J St
Ms 01-36
Tacoma, WA 98405-4933

Mailing address

1717 S J St
Ms 01-36
Tacoma, WA 98405-4933
Phone (253) 426-6363

Other identifiers 1

IdentifierTypeStateIssuer
0248725OtherWASTATE L & I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080207000122 WA Practitioner - HospitalistPractitioner - Internal Medicine 7012922545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 426-6341

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00045419WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Internal Medicine CurrentSince Apr 1, 2019 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Sep 15, 2018 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Sep 15, 2018 Accepting new patients
Franciscan Medical Group Past Accepting new patients
Franciscan Medical Group Past Accepting new patients
Northern Rhode Island Medical Group, PC Internal Medicine Past Accepting new patients
Saint Clare Hospital Past Accepting new patients

Locations

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

1717 S J St
#136
Tacoma, WA 98405
Phone (253) 426-6363

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: pvutla16865@fhsce.catholichealth.net

Organizations & group practices 9

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 5

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305417600000",
    "number": "1952369795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "address_2": "MS 01-36",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-6363",
            "fax_number": "253-426-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "address_2": "MS 01-36",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUTLA",
        "first_name": "PRAGATHY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2011-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "226667",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00045419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L & I",
            "identifier": "0248725",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.