MEDICARE: INNOCRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	261QP2300X	Primary Care Clinic/Center
3	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1881535565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOCRE

Provider Business Mailing Address
First Line	:	807 CATES WAY
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-4119
Country	:	US
Telephone Number	:	844-836-2669
Fax Number	:	351-207-3917

Provider Business Practice Location Address
First Line	:	14205 SE 36TH ST
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98006-1596
Country	:	US
Telephone Number	:	844-836-2669
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ATUL SKARIYA VELLAPPALLY
Credential	:	CRNP
Telephone Number	:	844-836-2669

Provider Enumeration Date	:	04/04/2026
Last Update Date	:	05/21/2026

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Directions to “INNOCRE ” Practice Location

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