Individual provider Active NPI

Aparna Pendurthi, M.D.

  • Vascular Neurology Physician
  • Mount Vernon, WA
National Provider Identifier
1962765230
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
MD61134654 Issued in WA
Practice address
1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone
(360) 428-2550
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X MD61134654 WA Primary

Addresses

Primary practice location

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Other identifiers 1

IdentifierTypeStateIssuer
2176849MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apendurthi80068@skagit.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA, WI, IL, OK, AR6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20210512003326 OR Practitioner - Neurology 7719253913 Reassigns benefits to 1 organization
I20210513000520 WA Practitioner - Neurology 7719253913 Reassigns benefits to 4 organizations
I20240806002068 WI Practitioner - Neurology 7719253913 Reassigns benefits to 1 organization
I20240912002664 IL Practitioner - Neurology 7719253913 Reassigns benefits to 1 organization
I20250912003092 OK Practitioner - Neurology 7719253913 Reassigns benefits to 1 organization
I20251106004410 AR Practitioner - Neurology 7719253913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health ServicesGroup PAC ID 0648514133, 103 clinicians

Practice addresses (Care Compare)

1500 Dodson Ave
Suite 290
Fort Smith, AR 72901-5182
Phone (479) 709-7175

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-19308ARMDVascular Neurology Physician
04-39928KSMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince May 6, 2021 Accepting new patients
Veeone Medical Group PA CurrentSince Jun 1, 2024 Accepting new patients
Baptist Health Services CurrentSince Oct 1, 2025 Accepting new patients
Legacy Clinics LLC CurrentSince May 6, 2021 Accepting new patients
Ccmma SC LLC CurrentSince Jul 1, 2025 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Oct 16, 2024 Accepting new patients
Warren Clinic Inc CurrentSince Sep 1, 2025 Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC CurrentSince Jul 19, 2024 Accepting new patients
Multicare Health System CurrentSince Oct 16, 2024 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince May 6, 2021 Accepting new patients
Baptist Health Services CurrentSince Oct 1, 2025 Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC Vascular Neurology CurrentSince Jul 19, 2024 Accepting new patients

Locations

1500 Dodson Ave
Ste 285B
Fort Smith, AR 72901
Phone (479) 709-7025

1500 Dodson Ave
Ste 290
Fort Smith, AR 72901
Phone (479) 573-7905

1120 Lexington Ave
Fort Smith, AR 72901
Phone (479) 709-7260

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

1420 E Roseville Pkwy
Ste 140519
Roseville, CA 95661

1850 W Winchester Rd
Ste 115
Libertyville, IL 60048
Phone (847) 816-6335

1860 W Winchester Rd
Ste 106
Libertyville, IL 60048
Phone (847) 599-0715

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

4600 Green Bay Rd
Kenosha, WI 53144
Phone (847) 816-6335

Interoperability endpoints

  • Direct secure messaging: apendurthi801763@direct.baptist-healthar.org

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1962765230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDURTHI",
        "first_name": "APARNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "WA",
            "license": "MD61134654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2176849",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apendurthi80068@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1400 E Kincaid St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.