Individual provider Active NPI

Rachael Marie Edwards, MD

  • Diagnostic Radiology Physician
  • Grand Rapids, MI
National Provider Identifier
1073837035
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD485081 Issued in PA
Practice address
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone
(616) 363-7272
Fax
(616) 361-5828
NPI assigned
Mar 19, 2010
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD485081 PA Primary
Diagnostic Radiology Physician 2085R0202X MD189604 OR
Diagnostic Radiology Physician 2085R0202X 4301505952 MI
Diagnostic Radiology Physician 2085R0202X MD60461707 WA

Addresses

Primary practice location

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746

Mailing address

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7272

Other practice location 1

2502 S Union Ave
Tacoma, WA 98405-1328
Phone (253) 761-9482

Other practice location 2

222 15th Ave SE
Puyallup, WA 98372-3754
Phone (253) 841-4353

Other practice location 3

1304 Fawcett Ave Ste 100
Tacoma, WA 98402
Phone (253) 761-4200

Other practice location 4

320 E North Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-2459

Other identifiers 6

IdentifierTypeStateIssuer
0389412OtherWALNI-TRA KING COUNTY
1073837035MedicaidWA
0389413OtherWALNI-UAOM
0389410OtherWALNI-TRA REST OF WA
0389414OtherWALNI-DINW
2019283MedicaidWA

Other names 1

  • Rachael Marie Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, PA, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20150605000064 WA Practitioner - Diagnostic Radiology 2365763174 Reassigns benefits to 5 organizations
I20240807003693 PA Practitioner - Diagnostic Radiology 2365763174 Reassigns benefits to 1 organization
I20250819001776 NY Practitioner - Diagnostic Radiology 2365763174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Washington School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chautauqua Medical Practice PCGroup PAC ID 5294920203, 103 clinicians
Allegheny Clinic RadiologyGroup PAC ID 8426364738, 153 clinicians

Practice addresses (Care Compare)

189 E Main St
Westfield, NY 14787-1104
Phone (716) 793-2221

320 E N Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-2459

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Current Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Jul 1, 2018 Accepting new patients
Proliance Surgeons Inc P S Family Medicine CurrentSince Jan 7, 2022 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Jan 7, 2022 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Jul 1, 2018 Accepting new patients
Chautauqua Medical Practice, P.C. Family Medicine CurrentSince Jun 13, 2025 Accepting new patients
Allegheny Clinic Radiology Diagnostic Radiology CurrentSince Jun 19, 2024 Accepting new patients
Radiologic Associates Prof Corp Diagnostic Radiology Past Accepting new patients
Saint Vincent Consultants in Cardiovascular Diseases Past Accepting new patients
St Vincent Medical Education and Research Institute Inc Family Medicine PastSince Jun 29, 2025 Accepting new patients

Locations

189 E Main St
Westfield, NY 14787
Phone (716) 326-4921

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

565 Coal Valley Rd
Jefferson Hls, PA 15025
Phone (412) 469-5308

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

222 15th Ave SE
Puyallup, WA 98372

1101 Madison St
Ste 580
Seattle, WA 98104
Phone (206) 400-7625

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

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

9601 Steilacoom Blvd SW
Tacoma, WA 98498
Phone (253) 582-8900

Interoperability endpoints

  • Direct secure messaging: rachael.edwards.p42@direct.proliance.nextgenshare.com
  • Direct secure messaging: redwards1126011@direct.hfhs.org
  • Direct secure messaging: redwards910057@direct.ahn.org

Organizations & group practices 11

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 10

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": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1073837035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2502 S Union Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984051328",
            "country_code": "US",
            "telephone_number": "253-761-9482",
            "fax_number": "253-759-6252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 15th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983723754",
            "country_code": "US",
            "telephone_number": "253-841-4353",
            "fax_number": "253-583-8630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1304 Fawcett Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "98402",
            "country_code": "US",
            "telephone_number": "253-761-4200",
            "fax_number": "253-761-4201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 E North Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152124756",
            "country_code": "US",
            "telephone_number": "412-359-2459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "RACHAEL",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD485081",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD189604",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301505952",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60461707",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-TRA KING COUNTY",
            "identifier": "0389412",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073837035",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-UAOM",
            "identifier": "0389413",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-TRA REST OF WA",
            "identifier": "0389410",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-DINW",
            "identifier": "0389414",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019283",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHAEL",
            "last_name": "DAVIS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.