DR. RAVILLA L MAHIDHAR (NPI# 1134346836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134346836 |
| Entity Type | Individual |
| Full Name | DR. RAVILLA L MAHIDHAR |
| Credential | MD |
| Practice Address |
12728 19th Ave Se Ste 200 Everett WA 98208-6526 |
| Mailing Address |
Po Box 3360 Portland OR 97208-3360 |
| Practice Telephone | 4252252700 |
| Mailing Telephone | (866) 366-2983 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2017-06-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
D81014 | MD | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
MD450900 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 213409800 | 05 | |
| WA | MEDICARE | G8910100 | 01 |
| MD | BCBS | AT540010 | 01 |
| Street Address |
12728 19TH AVE SE STE 200 |
| City | EVERETT |
| State | WA |
| Zip Code | 98208-6526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376660472 | Leigh R. Anderson | Internal Medicine | 12728 19th Ave Se Ste 200, Everett, WA 98208 | 2007-03-23 |
| 1275192841 | Darya C Khalili | Nurse Practitioner | 12728 19th Ave Se Ste 200, Everett, WA 98208-6526 | 2019-06-07 |
| 1679992903 | Stephanie Abbott | Pharmacist | 12728 19th Ave Se Ste 200, Everett, WA 98208-6526 | 2014-04-15 |
| 1417219874 | Joshua Schilling | Internal Medicine | 12728 19th Ave Se Ste 200, Everett, WA 98208 | 2012-06-12 |
| 1336405539 | Michael Adel Eskander | Internal Medicine | 12728 19th Ave Se Ste 200, Everett, WA 98208-6526 | 2012-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790270296 | Kenneth Britt Dyer | Registered Nurse | 10333 19th Ave, Se, Ste #109, Everett, WA 98208 | 2018-06-27 |
| 1518482215 | Glacier Peak Healthcare, Inc. | Home Health | 10530 19th Ave Se Ste 201, Everett, WA 98208 | 2017-08-03 |
| 1114454865 | Aliza Kreisman | Registered Nurse | 11020 19th Avenue Se, Kaiser Permanente of Washington Seattle Care Clinic, Everett, WA 98208 | 2017-05-12 |
| 1902269418 | Clay Eakin | Counselor | 2732 Grand Evenue, Everett, WA 98208 | 2016-04-01 |
| 1467810259 | Elizabeth Anne Powley | Marriage & Family Therapist | 1920 100th Street Southeast, Bld C3, Everett, WA 98208 | 2016-02-08 |
| 1659745842 | Andrea Rose Bedlington | Pharmacist | 11407 33rd Dr. Se, Everett, WA 98208 | 2015-11-25 |
| 1396123865 | Sound Surgeons Pllc | Clinic/Center | 125 130th Street Se, 1st Floor, Everett, WA 98208 | 2015-05-15 |
| 1831576537 | Chris Sturgeon | Counselor | 10102 Meridian Ave, Everett, WA 98208 | 2015-05-01 |
| 1982011128 | James M Lee | Physical Therapist | 10821 19th Ave Se Ste 102, Everett, WA 98208 | 2014-07-21 |
| 1972937357 | Ronald Tracy | Dentist | 10315 19th Avenue Se Suite 110, Everett, WA 98208 | 2013-08-21 |
| Find all providers in zip 98208 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982905923 | J. Randall Farrar, Md | Internal Medicine | 1155 Jadwin Ave, Richland, WA 99352-3434 | 2010-11-08 |
| 1679522106 | Inland Cardiology Associates, P.s. | Internal Medicine | 122 West 7th Avenue, Suite 450, Spokane, WA 99204-4332 | 2006-05-10 |
| 1871986455 | Sunnyside Community Hospital Association | Internal Medicine | 812 Miller Ave, Sunnyside, WA 98944-2374 | 2015-03-06 |
| 1568892586 | Shenjing Li | Internal Medicine | 200 Ne Mother Joseph Pl Ste 400, Vancouver, WA 98664-3290 | 2013-11-13 |
| 1023389061 | Henry Chu | Internal Medicine | 700 Ne 87th Ave Ste 210, Vancouver, WA 98664 | 2012-01-23 |
| 1225311756 | Danny Dvir | Internal Medicine | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2011-09-21 |
| 1841510310 | Kenta Nakamura | Internal Medicine | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2010-06-08 |
| 1588989032 | Patrick John Goleski | Internal Medicine | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2010-03-27 |
| 1508196833 | Jacob Appel Doll | Internal Medicine | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2010-01-08 |
| 1811225923 | Gopal Ghimire | Internal Medicine | 500 Lilly Rd Ne Ste 100, Providence Cardiology Associates, Olympia, WA 98506-5195 | 2009-12-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. RAVILLA L MAHIDHAR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.