PRAVEEN KUMAR MAMBALAM (M.D.) – Pain Medicine (Anesthesiology) Physician, NPI 1790942886
Pain Medicine (Anesthesiology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
141 PAIN MANAGEMENT in WA
Provider Addresses for PRAVEEN KUMAR MAMBALAM (M.D.)
155 Lilly Rd NE Ste B
Olympia, WA 985065028
Phone: (206) 538-6300
Fax: (206) 538-6301
Type: Location
PO BOX 827
BELLEVUE, WA 980090827
Phone: (425) 774-1538
Fax: (425) 744-1527
Type: Mailing
Edmonds Medical Plaza, 21616, 76th Avenue West, Perrinville, Edmonds, Snohomish County, Washington, 98026, United States
STE 102
EDMONDS, WA 980267512
Phone: (425) 774-1538
Fax: (425) 744-1527
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 100 Open Payments records for all available years, with a total value of $8,066.
Total Amount is formed as General ($8,066) + Research ($0) + Ownership ($0) = $8,066.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Medtronic, Inc. ($4,326).
Total Amount
$8,066
General + Research + Ownership
Payments
100
Total payment records
General Amount
$8,066
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $4,326 |
| SI-BONE, INC. | $1,397 |
| Nalu Medical, Inc. | $665 |
| Abbott Laboratories | $446 |
| Nevro Corp. | $405 |
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: 2024-05-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
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 |
|---|---|---|---|---|
| I20090323000363 | I | Anesthesiology | WA | TBD |
| I20170419001483 | I | Pain Management | OR | TBD |
| I20240124000595 | I | Anesthesiology | FL | TBD |
| I20240223002411 | I | Anesthesiology | MD | TBD |
| I20240507000764 | I | Anesthesiology | DC | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 371 | 127 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 166 | 70 | $0 |
| 99152 | Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes | 75 | 49 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 57 | 57 | $0 |
| 63650 | Insertion of spinal neurostimulator electrode array through skin | 47 | 16 | $0 |
Insurance plans in this area (ZIP 98506)
Loading plans...
Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | VA | |
| Nurse Practitioner | PA | |
| Nurse Practitioner | PA | |
| Nurse Practitioner | MD | |
| Nurse Practitioner | MD | |
| Nurse Practitioner | VA | |
| Physician Assistant | WV | |
| Nurse Practitioner | VA | |
| - | MD | |
| Pain Management, Physical Medicine And Rehabilitation | MD |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.