Praveen Kumar Mambalam, MD in Edmonds, WA

Praveen Kumar Mambalam, MD is a medicare enrolled "Anesthesiology - Pain Medicine" physician in Edmonds, Washington. He went to Virginia Commonwealth University, School Of Medicine and graduated in 2004 and has 20 years of diverse experience with area of expertise as Anesthesiology. He is a member of the group practice Washington Center For Pain Management Llc and his current practice location is 21616 76th Ave W, Ste 102, Edmonds, Washington. You can reach out to his office (for appointments etc.) via phone at (425) 774-1538.

Praveen Kumar Mambalam is licensed to practice in Washington (license number MD 00049423) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1790942886.

Contact Information

	Praveen Kumar Mambalam, MD
	21616 76th Ave W, Ste 102, Edmonds, WA 98026-7512
	(425) 774-1538
	(425) 744-1527

Map and Direction

Physician's Profile

Full Name	Praveen Kumar Mambalam
Gender	Male
Speciality	Anesthesiology
Experience	20 Years
Location	21616 76th Ave W, Edmonds, Washington
Accepts Medicare Assignments	May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Praveen Kumar Mambalam attended and graduated from Virginia Commonwealth University, School Of Medicine in 2004

NPI Data:

NPI Number: 1790942886
Provider Enumeration Date: 05/17/2008
Last Update Date: 05/23/2023

Medicare PECOS Information:

PECOS PAC ID: 5597822387
Enrollment ID: I20090323000363

Medical Identifiers

Medical identifiers for Praveen Kumar Mambalam such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1790942886	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207LP2900X	Anesthesiology - Pain Medicine	MD 00049423 (Washington)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Washington Center For Pain Management Llc	0143329169	7

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Praveen Kumar Mambalam allows following entities to bill medicare on his behalf.

Entity Name	Robert G R Lang Md Inc Ps
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1447329412 PECOS PAC ID: 4981594538 Enrollment ID: O20040317000881

Entity Name	Washington Center For Pain Management Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194381905 PECOS PAC ID: 0143329169 Enrollment ID: O20070615000367

Entity Name	Pain Care Physicians Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144779232 PECOS PAC ID: 9537448931 Enrollment ID: O20161107001926

Entity Name	Pain Care Physicians Pllc
Entity Type	Part B Supplier - Ambulatory Surgical Center
Entity Identifiers	NPI Number: 1144779232 PECOS PAC ID: 9537448931 Enrollment ID: O20200424000295

Entity Name	Washington Pain And Spine Specialists Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1992486906 PECOS PAC ID: 7315381639 Enrollment ID: O20240214003694

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Praveen Kumar Mambalam is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Praveen Kumar Mambalam, MD Po Box 827, Bellevue, WA 98009-0827 Ph: (425) 774-1538	Praveen Kumar Mambalam, MD 21616 76th Ave W, Ste 102, Edmonds, WA 98026-7512 Ph: (425) 774-1538

Reviews and Comments

Anesthesiology Doctors in Edmonds, WA

Babu Rajendran, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 21601 76th Ave W, Edmonds, WA 98026 Phone: 425-640-4000 Fax: 206-672-0211
Carolyn G. Miller, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 21601 76th Ave W, Edmonds, WA 98026 Phone: 425-640-4000 Fax: 206-672-0211
Brendan Rhodes O'donnell, Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 21616 76th W Ave, Suite 209, Edmonds, WA 98026 Phone: 425-774-5163 Fax: 425-744-1705
David Inadomi, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 21601 76th Ave W, Edmonds, WA 98026 Phone: 425-640-4000 Fax: 206-672-0211
Patrick Cheng-ann Lee, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 21601 76th Ave W, Edmonds, WA 98026 Phone: 425-640-4000
Ms. Jessica Kristine Lee, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 21601 76th Ave W, Edmonds, WA 98026 Phone: 425-640-4000
Teresa Marie Schlesinger, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 21616 76th Ave W, Suite #112, Edmonds, WA 98026 Phone: 425-775-6651 Fax: 425-670-6718

Praveen Kumar Mambalam, MD - Medicare Anesthesiology in Edmonds, WA