Individual provider Active NPI

Reid Roberts Bennett, MD

  • Anesthesiology Physician
  • Vancouver, WA
National Provider Identifier
1033504261
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD60926124 Issued in WA
Practice address
505 NE 87TH Ave Ste 210
Vancouver, WA 98664
Phone
(363) 828-5396
NPI assigned
Apr 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X MD60926124 WA Primary

Addresses

Primary practice location

505 NE 87TH Ave Ste 210
Vancouver, WA 98664

Mailing address

505 NE 87TH Ave Ste 210
Vancouver, WA 98664-1988
Phone (363) 828-5396

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8211

Other practice location 2

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190708001890 WA Practitioner - Anesthesiology 5890003636 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tacoma Anesthesia Associates Inc PSGroup PAC ID 6002704475, 63 clinicians

Practice addresses (Care Compare)

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone (253) 274-1668

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Aug 13, 2023 Accepting new patients
Franciscan Medical Group Anesthesiology CurrentSince Aug 13, 2023 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Pacific Anesthesia PC Anesthesiology CurrentSince Jul 15, 2022 Accepting new patients
Tacoma Anesthesia Associates Inc PS Anesthesiology CurrentSince Jun 30, 2023 Accepting new patients

Locations

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1033504261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 NE 87TH AVE STE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641988",
            "telephone_number": "363-828-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NE 87TH AVE STE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98664",
            "telephone_number": "363-828-5396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "REID",
        "middle_name": "ROBERTS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD60926124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.