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MADHURI KANDALA
NPI 1952494874
Internal Medicine - Nephrology in Bellevue, WA

Active since October 02, 2006PECOS EnrolledAccepts Medicare Assignment
99.21/100
CMS Quality Rating
1370 116TH AVE NE, SUITE 209, BELLEVUE, WA 98004(425) 453-8406(425) 453-4173 Get Directions Write a Review

NPPES record last updated: June 28, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Madhuri Kandala NPPES

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

MADHURI KANDALA (NPI 1952494874) is an individual nephrology provider in Bellevue, Washington, licensed in Washington (MD00042273) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS, is affiliated with Overlake Hospital Medical Center, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1952494874
Entity TypeIndividualFemale
Primary Taxonomy207RN0300X
Provider Legal NameMADHURI KANDALA
Location Address1370 116TH AVE NE, SUITE 209Bellevue, WA 98004-3825
Mailing Address1370 116th Ave Ne, Suite 209Bellevue, WA 98004-3825 · (425) 453-8406 · Fax (425) 453-4173
Phone(425) 453-8406
Fax(425) 453-4173
Sole ProprietorYes
Medical School CMSOtherGraduated 1996
Enumeration DateOctober 2, 2006
Last NPPES UpdateJune 28, 2019
✔ NPI 1952494874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in WA · MD00042273
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
1370 116TH AVE NE, Bellevue, WA 98004
Open in Google Maps ↗

Other Identifiers 1

Medicaid1123520WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Madhuri Kandala 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 ID6002919255
PECOS Enrollment IDI20070309000009
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.

Areas of Expertise CMS Part B claims 10

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.
134 services69 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
132 services69 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
102 services51 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
64 services17 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
47 services12 patients
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.
47 services42 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Overlake Hospital Medical Center

Acute Care Hospitals · Bellevue, WA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number500051
Location1035-116th Ave NEBellevue, WA 98004 · King County
Emergency services Birthing friendly

Evergreenhealth Monroe

Acute Care Hospitals · Monroe, WA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number500084
Location14701 179th Ave SEMonroe, WA 98272 · Snohomish County
Emergency services

Evergreenhealth Medical Center

Acute Care Hospitals · Kirkland, WA
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number500124
Location12040 NE 128th StreetKirkland, WA 98034 · King County
Emergency services Birthing friendly

Peacehealth United General Medical Center

Critical Access Hospitals · Sedro Woolley, WA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number501329
Location2000 Hospital DriveSedro Woolley, WA 98284 · Skagit County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98004 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
$143.76 typical visit price
range $63.67 – $189.37
Typical copayment $35.94 (range $15.91 – $47.34)
Most-billed visit code 99204
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

99.21/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality97.15
Promoting Interoperability100
Improvement Activities40
Cost83.57

Reported Quality Measures

Breast Cancer Screening
76%42 patients4/55-star benchmark: 93%
Cervical Cancer Screening
36%39 patients2/55-star benchmark: 98%
Colorectal Cancer Screening
39%108 patients2/55-star benchmark: 88%
Controlling High Blood Pressure
67%123 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
21%56 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
23%56 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
94%495 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
54%195 patients3/55-star benchmark: 100%
Functional Status Assessments for Heart Failure
0%22 patients
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
32%263 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
26%202 patients2/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
47%106 patients4/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 98% · 114 patients
96%114 patients
Provide Patients Electronic Access to Their Health Information
100%107 patients5/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
89%162 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 12% · 177 patients
Patients totalRate: 19% · 177 patients
16%177 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Cyclosporine, oral, 100 mg J7502
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers12 claims360 services$1.52 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
6 suppliers34 claims3,705 services$0.34 avg. paid by Medicare
Cyclosporine, oral, 25 mg J7515
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers13 claims1,170 services$0.54 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers13 claims1,170 services$0.18 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
5 suppliers15 claims2,040 services$0.95 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
6 suppliers33 claims33 services$18.38 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

BELLEVUE PODIATRY INC.
Podiatrist (Foot & Ankle Surgery)
1370 116TH AVE NE, STE. 206
BELLEVUE, WA 98004
King County (425) 450-0565
DR. MELODY C. LIBATIQUE DC
Chiropractor
1370 116TH AVE NE
BELLEVUE, WA 98004
King County (424) 454-0199
STERN CENTER FOR AESTHETIC SURGERY INC
Clinic/Center (Ambulatory Surgical)
1370 116TH AVE NE, SUITE 102
BELLEVUE, WA 98004
King County (425) 455-9100
EUGENE DELL KATO DDS
Dentist (General Practice)
1370 116TH AVE NE, #104
BELLEVUE, WA 98004
King County (425) 454-8261
DR. LORNE D. TRIMBLE DMD, MD
Dentist (Oral and Maxillofacial Surgery)
1370 116TH AVE NE, STE 101
BELLEVUE, WA 98004
King County (425) 453-6975
HONGPING REN LAC
Acupuncturist
1370 116TH AVE NE, SUITE 208
BELLEVUE, WA 98004
King County (425) 646-6888
DR. LARRY WILLIAM EINSPAHR MD
Psychiatry & Neurology (Psychiatry)
1370 116TH AVE NE, SUITE 201
BELLEVUE, WA 98004
King County (425) 455-2818
LIN LI M.D.
Internal Medicine (Nephrology)
1370 116TH AVE NE, SUITE 209
BELLEVUE, WA 98004
King County (425) 453-8406

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Madhuri Kandala's NPI number?

The NPI number for Madhuri Kandala is 1952494874. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Where is Madhuri Kandala located?

Madhuri Kandala practices at 1370 116th Ave NE Suite 209, Bellevue, WA 98004. The listed phone number is (425) 453-8406.

What is Madhuri Kandala's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Madhuri Kandala enrolled in Medicare?

Yes. Madhuri Kandala is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Madhuri Kandala accept?

Health plans from PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Madhuri Kandala as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Madhuri Kandala affiliated with any hospitals?

According to CMS data, Madhuri Kandala is affiliated with Overlake Hospital Medical Center, Evergreenhealth Monroe, Evergreenhealth Medical Center and Peacehealth United General Medical Center.

When was this NPI record last updated?

The NPPES record for Madhuri Kandala was last updated on June 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.