Individual provider Active NPI

Phillip C. Lesh, M.D

Diagnostic Radiology Physician
Tacoma, WA

National Provider Identifier

1093888091

Registry record updated Dec 22, 2016

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices2
NPI Registry JSON
Other providers in Tacoma, WA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License: MD00023770 Issued in WA
Practice address: 1304 Fawcett Ave
Suite 100
Tacoma, WA 98402-1911
Phone: (253) 761-4200
Fax: (253) 383-3553
NPI assigned: Nov 16, 2006
Sex: Male
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)	Code	License	State	Primary
Nuclear Radiology Physician	2085N0904X	00023770	WA
Diagnostic Radiology Physician	2085R0202X	MD00023770	WA	Primary

Addresses

Primary practice location

1304 Fawcett Ave
Suite 100
Tacoma, WA 98402-1911

Mailing address

PO Box 1535
Tacoma, WA 98401-1535
Phone (253) 761-4200

Other identifiers 13

Identifier	Type	State	Issuer
8944811	Other	WA	LABOR AND INDUSTRIES CRIME VICTIMS-TRA
8945535	Other	WA	LABOR AND INDUSTRIES CRIME VICTIMS-UNION AVENUE OPEN MRI
AB36527	Other	WA	MEDICARE PIN TRA KING COUNTY
LE4084	Other	WA	REGENCE BLUE SHIELD TRA
119259	Other	WA	LABOR AND INDUSTRIES/WC UNION AVENUE OPEN
40721	Other	WA	LABOR AND INDUSTRIES/WC TRA
300023013	Other	WA	RR MEDICARE TRA
G8892476	Other	WA	PTAN-DOCTORS CLINIC
LE7252	Other	WA	REGENCE BLUE SHIELD UNION AVENUE OPEN
0249526	Other	WA	LABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST
8125379	Medicaid	WA
8951850	Other	WA	LABOR AND INDUSTRIES CRIME VICTIMS-MEDICAL IMAGING ON 1ST
G8881780	Other	WA	PTAN-MIO1

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

Part B services: No
Medical equipment: Yes
Home health: No
Power mobility devices: Yes
Hospice: No

Green means eligible to order or refer.

National Provider Directory

Medicare enrollment (NPD): Enrolled
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
00023770	WA	MD	Nuclear Radiology Physician

Practice roles

Organization	Specialty	Status	New patients
Tra-Minw P S		Past	Accepting new patients
Tacoma Magnetic Imaging LP		Past	Accepting new patients

Organizations & group practices 2

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.

Tacoma Magnetic Imaging LP
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1376612069
NPD (past)
Tra-Minw P S
- Radiology Clinic/Center
- Federal Way, WA
- NPI 1184790032
NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1093888091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1535",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984011535",
            "telephone_number": "253-761-4200",
            "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": "253-761-4200",
            "fax_number": "253-383-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESH",
        "first_name": "PHILLIP",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "WA",
            "license": "00023770",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00023770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES CRIME VICTIMS-TRA",
            "identifier": "8944811",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES CRIME VICTIMS-UNION AVENUE OPEN MRI",
            "identifier": "8945535",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN TRA KING COUNTY",
            "identifier": "AB36527",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD TRA",
            "identifier": "LE4084",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES/WC UNION AVENUE OPEN",
            "identifier": "119259",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES/WC TRA",
            "identifier": "40721",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE TRA",
            "identifier": "300023013",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN-DOCTORS CLINIC",
            "identifier": "G8892476",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD UNION AVENUE OPEN",
            "identifier": "LE7252",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST",
            "identifier": "0249526",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8125379",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES CRIME VICTIMS-MEDICAL IMAGING ON 1ST",
            "identifier": "8951850",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN-MIO1",
            "identifier": "G8881780",
            "state": "WA"
        }
    ],
    "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 Dec 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.