Individual provider Active NPI

Ruchi Thanawala, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Springfield, MA
National Provider Identifier
1992979645
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD201559 Issued in OR
Practice address
Baystate Medical Center
759 Chestnut St
Springfield, MA 01199-0001
Phone
(413) 794-0000
NPI assigned
Apr 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD61258693 WA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD61258693 WA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD201559 OR Primary

Addresses

Primary practice location

Baystate Medical Center
759 Chestnut St
Springfield, MA 01199-0001

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone (503) 494-7820

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone (503) 494-7820

Other practice location 2

200 NE Mother Joseph Pl Ste 320
Vancouver, WA 98664-3205
Phone (360) 514-6300

Other names 1

  • Dr. Ruchi Thanawala Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20201125002289 OR Practitioner - Cardiac Surgery 0941522304 Reassigns benefits to 1 organization
I20220921000956 WA Practitioner - Thoracic Surgery 0941522304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

200 NE Mother Joseph PL
Suite 320
Vancouver, WA 98664-3205
Phone (360) 514-6300

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61258693WAMDSurgery Physician
MD201559ORMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Nov 1, 2020 Accepting new patients
University Professional Services Current Accepting new patients
Peacehealth Surgery CurrentSince Aug 11, 2022 Accepting new patients
University Professional Services CurrentSince Nov 1, 2020 Accepting new patients
University Professional Services Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

200 NE Mother Joseph Pl
Ste 320
Vancouver, WA 98664
Phone (360) 514-6300

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1992979645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-7820",
            "fax_number": "503-494-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BAYSTATE MEDICAL CENTER",
            "address_2": "759 CHESTNUT ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011990001",
            "telephone_number": "413-794-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393098",
            "country_code": "US",
            "telephone_number": "503-494-7820",
            "fax_number": "503-494-7829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 NE Mother Joseph Pl Ste 320",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986643205",
            "country_code": "US",
            "telephone_number": "360-514-6300",
            "fax_number": "360-514-6301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THANAWALA",
        "first_name": "RUCHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD61258693",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD61258693",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OR",
            "license": "MD201559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUCHI",
            "last_name": "THANAWALA",
            "prefix": "DR.",
            "credential": "MD, MS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.