KUSUM RAI MD
NPI 1093277220
Family Medicine in Redmond, WA

Q: What is Kusum Rai's NPI number?

The NPI number for Kusum Rai is 1093277220. It was assigned to this individual provider in the NPPES registry on April 5, 2019.

Q: What is Kusum Rai's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kusum Rai was last updated on February 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 05, 2019PECOS EnrolledAccepts Medicare Assignment

16255 NE 87TH ST STE 150, REDMOND, WA 98052(425) 882-1697(425) 885-4179 Get Directions Write a Review

NPPES record last updated: February 9, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 12, 2026, Jan 8, 2025, Jan 4, 2025 and 1 more (4 updates tracked since 2019).

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About Kusum Rai Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KUSUM RAI MD (NPI 1093277220) is an individual family medicine provider in Redmond, Washington, licensed in Washington (MD61399969) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1093277220

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameKUSUM RAICredential: MD

Location Address16255 NE 87TH ST STE 150Redmond, WA 98052-7464

Mailing Address7259 S Bingham Junction BlvdMidvale, UT 84047-4860 · (800) 453-3030

Phone(425) 882-1697

Fax(425) 885-4179

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateApril 5, 2019

Last NPPES UpdateFebruary 9, 20264 updates tracked since enumeration

NPPES CertifiedFebruary 9, 2026

✔ NPI 1093277220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in WA · MD61399969✔ Licensed in OR · MD210992✔ Licensed in AZ · 71694

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

16255 NE 87TH ST STE 150, Redmond, WA 98052

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Secondary Practice Locations 2

Location 12929 E Thomas RdPhoenix, AZ 85016-8034 · Phone (602) 470-5000

Location 27259 S Bingham Junction BlvdMidvale, UT 84047-4860 · Phone (800) 453-3030

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kusum Rai Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID244560704

PECOS Enrollment IDI20221017001555, I20241227002806

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Kusum Rai reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Healthpoint

Same address

Federally Qualified Health Center (FQHC)

16255 NE 87TH ST STE 150
Redmond, WA 98052

Reassigned Medicare billing, Washington enrollment
403 clinicians in this Medicare group

NPI 1891795621 (425) 882-1697

Lane County Oregon

254 mi

Federally Qualified Health Center (FQHC)

2073 OLYMPIC ST
Springfield, OR 97477

Reassigned Medicare billing, Oregon enrollment
143 clinicians in this Medicare group

NPI 1326138314 (541) 682-3550

District Medical Group, Inc

1,114 mi

Surgery

2525 E ROOSEVELT ST, MED CLINIC - INFECTIOUS DISEASE
Phoenix, AZ 85008

Reassigned Medicare billing, Arizona enrollment
1,490 clinicians in this Medicare group

NPI 1174856280 (602) 344-1095

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

81 services68 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

13 services13 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98052 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$97.43 typical visit price

range $63.67 – $189.37

Typical copayment $24.35 (range $15.91 – $47.34)

Most-billed visit code 99203

Established Patient

$111.00 typical visit price

range $21.12 – $155.00

Typical copayment $27.75 (range $5.28 – $38.75)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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