NPIMap

Samuel J. Boynton, MD

Individual provider Active NPI Diagnostic Radiology Physician · Olympia, WA

NPI 1083827992 · NPPES record last updated May 24, 2018

Key facts

NPI
1083827992
Entity type
Individual (NPI type 1)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
MD60681523 (WA)
Practice address
3417 Ensign Rd NE
Olympia, WA 98506
Phone
(360) 493-4600
Fax
(360) 493-4603
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 38

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.

View all 38

Hospital & facility affiliations 7

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

Medicare Care Compare profile

Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Washington Health Services Association (708 clinicians)
Radia Inc P S (275 clinicians)
Swedish Health Services (156 clinicians)
Swedish Radia Imaging Center at Edmonds LLC (115 clinicians)
South Sound Radiologists Inc P S (76 clinicians)
Swedish Health Services (1,038 clinicians)

Practice addresses (Care Compare)

1201 S Miller St
Wenatchee, WA 98801-3201
Phone (509) 662-2208

12040 NE 128TH St
Kirkland, WA 98034-3013
Phone (425) 899-1800

18100 NE Union Hill Rd
Redmond, WA 98052-3330
Phone (425) 498-2030

21700 Hwy 99
Edmonds, WA 98026-8034
Phone (425) 297-6200

3417 Ensign Rd NE
Olympia, WA 98506-5064
Phone (360) 493-4600

515 Minor Ave
Suite 110
Seattle, WA 98104-2145
Phone (206) 386-9699

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital · Vancouver, WA · CCN 500050
  • Peacehealth St John Medical Center Hospital · Longview, WA · CCN 500041
  • Legacy Salmon Creek Medical Center Hospital · Vancouver, WA · CCN 500150
  • Swedish Medical Center Hospital · Seattle, WA · CCN 500027
  • Confluence Health Hospital Hospital · Wenatchee, WA · CCN 500016

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20161028001659 WA Practitioner - Diagnostic Radiology 0648435560 Reassigns benefits to 9 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301088520MIMDDiagnostic Radiology Physician
0101256955VAMDDiagnostic Radiology Physician
54901MNMDVascular & Interventional Radiology Physician
MD60681523WAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Current
since Mar 13, 2024		 Accepting new patients
Central Washington Health Services Association Current
since Jun 1, 2022		 Accepting new patients
South Sound Radiologists Inc P S Diagnostic Radiology Current
since Nov 1, 2016		 Accepting new patients
Swedish Health Services Current
since Jan 15, 2020		 Accepting new patients
Evergreen Radia LLC Diagnostic Radiology Current
since Sep 18, 2019		 Accepting new patients
Wenatchee Valley Hospital Current
since May 1, 2019		 Accepting new patients
Central Washington Health Services Association Current Accepting new patients
Swedish Radia Imaging Center at Edmonds LLC Diagnostic Radiology Current
since Sep 18, 2019		 Accepting new patients
Radia Inc P S Diagnostic Radiology Current
since Jan 1, 2018		 Accepting new patients
Radia Imaging Center Holdings LLC Diagnostic Radiology Current
since Jan 1, 2019		 Accepting new patients
Swedish Health Services Current
since Mar 13, 2024		 Accepting new patients

Locations

1200 112th Ave NE
Ste B250
Bellevue, WA 98004
Phone (206) 386-6266

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

21700 Highway 99
Edmonds, WA 98026
Phone (425) 640-4949

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

11521 NE 128th St
Ste 200
Kirkland, WA 98034
Phone (425) 952-6100

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

19020 33rd Ave W
Ste 210
Lynnwood, WA 98036
Phone 42556315001

1025 153rd St SE
Ste 200
Mill Creek, WA 98012
Phone (425) 338-4000

3417 Ensign Rd NE
Olympia, WA 98506
Phone (360) 493-4600

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

18100 NE Union Hill Rd
Redmond, WA 98052
Phone (425) 498-2020

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

1229 Madison St
Ste 900
Seattle, WA 98104
Phone (206) 292-6233

500 17th Ave
Seattle, WA 98122
Phone (206) 320-2111

515 Minor Ave
Ste 110
Seattle, WA 98104
Phone (206) 292-6233

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

4816 NE Thurston Way
Ste A
Vancouver, WA 98662
Phone (360) 254-4914

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301088520 MI
Diagnostic Radiology Physician 2085R0202X 0101256955 VA
Vascular & Interventional Radiology Physician 2085R0204X MD60681523 WA
Vascular & Interventional Radiology Physician 2085R0204X 54901 MN
Diagnostic Radiology Physician 2085R0202X MD60681523 WA Yes

Addresses

Primary practice location

3417 Ensign Rd NE
Olympia, WA 98506

Mailing address

3417 Ensign Rd NE
Olympia, WA 98506-5064
Phone (360) 493-4600

Other identifiers

IdentifierTypeStateIssuer
0375504OtherWALABOR & INDUSTRY
2068886MedicaidWA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 24, 2018.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1083827992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 ENSIGN RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065064",
            "telephone_number": "360-493-4600",
            "fax_number": "360-493-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 ENSIGN RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-493-4600",
            "fax_number": "360-493-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYNTON",
        "first_name": "SAMUEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301088520",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101256955",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD60681523",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MN",
            "license": "54901",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60681523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "0375504",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2068886",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

All providers in Olympia, WA · Diagnostic Radiology Physician in Washington

Sources for this page

Verify at the official NPI Registry.