Organization Active NPI

Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance

  • Radiology Clinic/Center
  • Tacoma, WA
National Provider Identifier
1083802946
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MEDICAL IMAGING NORTHWEST - GOOD SAMARITAN HOSPITAL IMAGING ALLIANCE
Practice address
1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone
(253) 761-4200
Fax
(253) 581-5698
NPI assigned
Oct 4, 2007
Last updated
Sep 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Authorized official

Name
Dr. Douglas P Seiler, M.D.NPI 1518076280
Title
President
Phone
(253) 761-4200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X NU Primary

Addresses

Primary practice location

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900

Mailing address

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone (253) 761-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, GA, AK, NY, MO, NJ, DC, NC, CA, FL, OR, CO, TX, AZ, NV, TN, MT, CT, MI, AL, UT, PA, IA, OK, SC, WI, MA, HI, MN29 enrollments

Enrollment records 29

Enrollment IDStateProvider typePAC IDDetails
O20081126000315 WA Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 150 practitioners
2 other NPIs on this enrollment
Practice locations: Olympia, WA; Puyallup, WA; Renton, WA; Seattle, WA; Shoreline, WA; Spokane, WA; Tacoma, WA; University Place, WA…
O20220803002181 GA Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 4 practitioners
Practice locations: Atlanta, GA; Decatur, GA; Duluth, GA; Evans, GA
O20220906001036 AK Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 3 practitioners
Practice locations: Fort Wainwright, AK; North Pole, AK; Eagle River, AK
O20220916001158 NY Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 14 practitioners
Practice locations: New York, NY; Melville, NY; Manlius, NY; Liverpool, NY; Jamesville, NY; Fayetteville, NY; Cornwall, NY; Camillus, NY
O20220928000516 MO Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 4 practitioners
Practice locations: Saint Robert, MO; Waynesville, MO; Saint Louis, MO
O20221010000077 NJ Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 4 practitioners
Practice locations: Wayne, NJ; Lawrence Township, NJ; Jersey City, NJ; Hoboken, NJ
O20221012003353 DC Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 4 practitioners
Practice locations: Gaithersburg, MD; Herndon, VA; MC Lean, VA; Potomac, MD
O20221101000593 NC Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 8 practitioners
Practice locations: Boone, NC; Asheville, NC; Whispering Pines, NC; New Bern, NC; Fayetteville, NC; Charlotte, NC
O20221210000408 CA Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 9 practitioners
Practice locations: Sunnyvale, CA; Santa Barbara, CA; San Diego, CA; Palm Desert, CA; Newbury Park, CA; Mountain View, CA; Los Gatos, CA; La Jolla, CA…
O20221228000968 FL Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 4 practitioners
Practice locations: Delray Beach, FL; Gulf Breeze, FL; Naples, FL; Port Orange, FL
O20230112001647 OR Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 5 practitioners
Practice locations: Portland, OR; Manzanita, OR; Lake Oswego, OR; Corvallis, OR; Bend, OR
O20230228000861 CO Part B Supplier - Clinic/Group Practice 3375603970 Practice locations: Colorado Springs, CO
O20230228002505 TX Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 7 practitioners
Practice locations: Plano, TX; Temple, TX; San Antonio, TX; Prosper, TX; Houston, TX; Austin, TX
O20230929002847 AZ Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 3 practitioners
Practice locations: Glendale, AZ; Mesa, AZ; Peoria, AZ; Phoenix, AZ
O20231005001539 NV Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Henderson, NV
O20231006001238 TN Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 1 practitioner
Practice locations: Clarksville, TN
O20231018002518 MT Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 1 practitioner
Practice locations: Whitefish, MT
O20231019003661 CT Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 1 practitioner
Practice locations: Darien, CT
O20231023000302 MI Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 1 practitioner
Practice locations: Royal Oak, MI
O20231023002010 AL Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 1 practitioner
Practice locations: Vestavia, AL
O20231025003620 UT Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 2 practitioners
Practice locations: Eden, UT; Huntsville, UT; Holladay, UT
O20240703002813 PA Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 4 practitioners
Practice locations: Chesterbrook, PA; Gladwyne, PA; Harrisburg, PA; Media, PA
O20240801003617 IA Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 1 practitioner
Practice locations: Pella, IA
O20241216001109 OK Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 4 practitioners
Practice locations: Oklahoma City, OK; Broken Arrow, OK; Tulsa, OK; Ramona, OK
O20250903002229 SC Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 1 practitioner
Practice locations: Anderson, SC
O20251021002068 WI Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 1 practitioner
Practice locations: Milwaukee, WI
O20260213001131 MA Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 1 practitioner
Practice locations: Dartmouth, MA
O20260223003402 HI Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 2 practitioners
Practice locations: Kihei, HI
O20260304003628 MN Part B Supplier - Clinic/Group Practice 3375603970 Receives reassigned benefits from 1 practitioner
Practice locations: Chaska, MN

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

11212 Sunrise Blvd E
Ste 200
Puyallup, WA 98374

Practitioners & affiliated clinicians

Practitioners 224

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 224

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1083802946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200",
            "fax_number": "253-845-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200",
            "fax_number": "253-581-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL IMAGING NORTHWEST - GOOD SAMARITAN HOSPITAL IMAGING ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2022-09-09",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "SEILER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-761-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.