DR. SUSHANTH NAYAK (MD) – Family Medicine Physician, NPI 1710273958
Family Medicine Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
4,141 FAMILY PRACTICE in WA
Provider Addresses for DR. SUSHANTH NAYAK (MD)
PO BOX 3360
PORTLAND, OR 972083360
Phone: (360) 486-6508
Fax: (360) 729-2724
Type: Mailing
4800 COLLEGE ST SE
LACEY, WA 985034389
Phone: (360) 486-2900
Fax: (360) 486-2901
Type: Location
2450 W HUNTING PARK AVE
PHILADELPHIA, PA 191291302
Phone: (215) 926-9022
Fax: (215) 226-8286
Type: Mailing
11000 ROOSEVELT BLVD UNIT 360
PHILADELPHIA, PA 191163961
Phone: (215) 677-1475
Fax: (215) 677-3082
Type: Location
4800 College St SE
Lacey, WA 985034389
Phone: (360) 486-2900
Fax: (360) 486-2901
Type: Location
1620 Cooper Point Rd SW
Olympia, WA 985025736
Phone: (360) 486-6710
Fax: (360) 705-0614
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-08-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140820002891 | I | Family Practice | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97208)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| Nurse Practitioner | OR | |
| - | OR | |
| Emergency Medicine | OR | |
| Family Practice | OR | |
| Family Practice | KS | |
| Family Practice | OR | |
| Clinical Social Worker | OR | |
| - | OR | |
| Nurse Practitioner | WA |
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