Active NPI
Edward Scott Casselman, MD
- Diagnostic Radiology Physician
- Everett, WA
National Provider Identifier
1003803776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD00017896
- Practice address
- 1321 Colby Ave
Everett, WA 98201-1665 - Phone
- (425) 261-4100
- NPI assigned
- Sep 28, 2005
- Last updated
- Dec 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD00017896 | WA | Primary |
Addresses
Primary practice location
1321 Colby Ave
Everett, WA 98201-1665
Mailing address
728 134TH St SW
Suite 120
Everett, WA 98204-5322
Phone (425) 297-6200
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00368452 | Other | WA | RAILROAD MEDICARE |
| 8197204 | Medicaid | WA | |
| 115844 | Other | WA | LABOR & IND. PROVIDER NO. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00017896 | WA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swedish Radia Imaging Center at Edmonds LLC | Diagnostic Radiology | Past | Accepting new patients |
| Swedish Medical Center-Radia Issaquah Imaging Center LLC | Diagnostic Radiology | Past | Accepting new patients |
| Everett Radia LLC | Diagnostic Radiology | Past | Accepting new patients |
| Evergreen Radia LLC | Diagnostic Radiology | Past | Accepting new patients |
| Radia Inc P S | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Swedish Radia
- Diagnostic Radiology Physician
- Issaquah, WA
- NPI 1427001312
-
dba Swedish Radia Edmonds
- Diagnostic Radiology Physician
- Edmonds, WA
- NPI 1164494373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196812800000",
"number": "1003803776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "728 134TH ST SW",
"address_2": "SUITE 120",
"city": "EVERETT",
"state": "WA",
"postal_code": "982045322",
"telephone_number": "425-297-6200",
"fax_number": "425-297-6250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1321 COLBY AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982011665",
"telephone_number": "425-261-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSELMAN",
"first_name": "EDWARD",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-28",
"last_updated": "2007-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "MD00017896",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00368452",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8197204",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & IND. PROVIDER NO.",
"identifier": "115844",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.