NPIMap

Individual provider Active NPI

Chuck Donald Martin, M.D.

  • Diagnostic Radiology Physician
  • Tacoma, WA
National Provider Identifier
1053346403
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD00041978 Issued in WA
Practice address
1304 Fawcett Ave
Suite 100
Tacoma, WA 98402-1911
Phone
(253) 680-3372
Fax
(253) 383-3553
NPI assigned
Jul 12, 2006
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD00041978 WA Primary

Addresses

Primary practice location

1304 Fawcett Ave
Suite 100
Tacoma, WA 98402-1911

Mailing address

1304 Fawcett Ave
Suite 100
Tacoma, WA 98402-1911
Phone (253) 680-3372

Other identifiers 2

IdentifierTypeStateIssuer
8353732MedicaidWA
1001250MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040427001393 WA Practitioner - Diagnostic Radiology 4688661192 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tra-Minw P SGroup PAC ID 2163316167, 152 clinicians

Practice addresses (Care Compare)

16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (253) 841-4353

3402 S 18TH St
Tacoma, WA 98405-1903
Phone (253) 841-4353

34515 9TH Ave S
Federal Way, WA 98003-6761
Phone (253) 841-4353

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD065380LPAMDOtolaryngology Physician
MD00041978WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Aug 1, 2016 Accepting new patients
Tra-Minw P S CurrentSince Aug 1, 2015 Accepting new patients
Tra-Minw P S CurrentSince Aug 1, 2015 Accepting new patients
Tra Medical Imaging Centers LLC CurrentSince Dec 1, 2025 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Aug 1, 2015 Accepting new patients
Northern Indiana Magnetic Resonance Center, LLP Past Accepting new patients
Univ of Penn-Otorhinolaryngology PastSince Jul 31, 1995 Accepting new patients
Highline Medical Center Past Accepting new patients
Radiology, Inc Diagnostic Radiology Past Accepting new patients
XRC Medical Imaging, LLC Diagnostic Radiology Past Accepting new patients
X-Ray Consultants Inc Diagnostic Radiology Past Accepting new patients
Memorial Hospital of South Bend Past Accepting new patients

Locations

5900 State Highway 303 NE
Bremerton, WA 98311
Phone (253) 459-6633

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

275 SW 160th St
Burien, WA 98166
Phone (206) 988-5744

33915 1st Way S
Ste 130
Federal Way, WA 98003
Phone (253) 528-9135

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

4700 Point Fosdick Dr
Ste 110
Gig Harbor, WA 98335
Phone (253) 759-2622

9725 SE 36th St
Ste 114
Mercer Island, WA 98040

500 Lilly Rd NE
Ste 160
Olympia, WA 98506
Phone (360) 413-8307

222 15th Ave SE
Puyallup, WA 98372

3400 California Ave SW
Seattle, WA 98116
Phone (206) 320-3399

1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372

2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900

3402 S 18th St
Tacoma, WA 98405
Phone (253) 383-1099

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ei-trami

Organizations & group practices 12

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.

Hospital & facility affiliations 7

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1053346403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE",
            "address_2": "SUITE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021911",
            "telephone_number": "253-680-3372",
            "fax_number": "253-383-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE",
            "address_2": "SUITE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021911",
            "telephone_number": "253-680-3372",
            "fax_number": "253-383-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHUCK",
        "middle_name": "DONALD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00041978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8353732",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001250",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.