NPIMap

Individual provider Active NPI

Gary Gordon Benjamin, MD

  • Vascular & Interventional Radiology Physician
  • Tacoma, WA
National Provider Identifier
1164595286
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD00034148 Issued in WA
Practice address
1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone
(253) 761-4200
Fax
(253) 761-4201
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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 MD00034148 WA
Diagnostic Radiology Physician 2085R0202X MD21111 OR
Vascular & Interventional Radiology Physician 2085R0204X MD00034148 WA Primary
Vascular & Interventional Radiology Physician 2085R0204X MD21111 OR

Addresses

Primary practice location

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900

Mailing address

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

Other identifiers 6

IdentifierTypeStateIssuer
0372658OtherWAL&I-DIAGNOSTIC IMAGING NW
0127162OtherWAL&I-TRA KING COUNTY
500670859MedicaidOR
1031136MedicaidWA
0186167OtherWAL&I-UNION AVE OPEN MRI
0335999OtherWAL&I-TRA REST OF WA

Other names 1

  • Gordon Benjamin Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040621000503 WA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 8325023880 Reassigns benefits to 4 organizations
I20140716002576 OR Practitioner - Diagnostic Radiology 8325023880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Medical College of Wisconsin, 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)

1515 Dock St
Unit 223
Tacoma, WA 98402-3254
Phone (251) 761-4200

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

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

2502 S Union Ave
Tacoma, WA 98405-1328
Phone (253) 841-4353

2801 St Anthony Way
Pendleton, OR 97801-3800
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

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 841-4353

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141
  • Highline Medical Center Hospital, Burien, WA, CCN 500011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21111ORMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Mar 1, 2017 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Mar 1, 2017 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Oct 5, 2011 Accepting new patients
Tra Medical Imaging Centers LLC CurrentSince Dec 1, 2025 Accepting new patients
Tacoma Magnetic Imaging LP Past Accepting new patients
Mercer Island Medical Imaging, LLC PastSince Nov 1, 2009 Accepting new patients
Tra-Minw P S Past Accepting new patients

Locations

122 3rd St NE
Auburn, WA 98002
Phone (253) 833-7750

2512 Wheaton Way
#O
Bremerton, WA 98310
Phone (360) 782-3700

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

2512 Wheaton Way
Bremerton, WA 98310
Phone (360) 782-3650

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

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

1724 West Union Ave
Ste 100
Tacoma, WA 98405
Phone (253) 830-5200

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

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

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

1624 S I St
Ste 405
Tacoma, WA 98405
Phone (253) 274-4545

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

5919 100th St SW
Tacoma, WA 98499

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

Interoperability endpoints

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

Organizations & group practices 8

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.

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1164595286",
    "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 STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200",
            "fax_number": "253-761-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "GARY",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00034148",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD21111",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD00034148",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OR",
            "license": "MD21111",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-DIAGNOSTIC IMAGING NW",
            "identifier": "0372658",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-TRA KING COUNTY",
            "identifier": "0127162",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500670859",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031136",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-UNION AVE OPEN MRI",
            "identifier": "0186167",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-TRA REST OF WA",
            "identifier": "0335999",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GORDON",
            "last_name": "BENJAMIN",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.