NPIMap

Organization Active NPI

Tumor Institute Radiation Oncology Group LLP

  • Radiation Oncology Physician
  • Seattle, WA
National Provider Identifier
1184632572
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
TUMOR INSTITUTE RADIATION ONCOLOGY GROUP LLP
Practice address
1221 Madison St
First Floor
Seattle, WA 98104-3589
Phone
(206) 386-2323
Fax
(206) 385-6150
NPI assigned
Aug 3, 2006
Last updated
Jul 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
Mary Monahan
Title
Administrator
Phone
(206) 320-7129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X Primary

Addresses

Primary practice location

1221 Madison St
First Floor
Seattle, WA 98104-3589

Mailing address

PO Box 749730
Los Angeles, CA 90074-9730
Phone (888) 709-4485

Other practice location 1

550 17th Ave Ste A10
Seattle, WA 98122-5789
Phone (206) 320-7130

Other identifiers 2

IdentifierTypeStateIssuer
7805203MedicaidWA
CS0846OtherWARAILROAD MEDICARE-PALMETTO GBA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040227000830 WA Part B Supplier - Clinic/Group Practice 3779470463 Receives reassigned benefits from 22 practitioners
Practice locations: Issaquah, WA; Renton, WA; Seattle, WA; Edmonds, WA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

21605 76th Ave W
Ste 100
Edmonds, WA 98026
Phone (425) 640-4300

500 17th Ave
Ste A10
Seattle, WA 98122

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1184632572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749730",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900749730",
            "telephone_number": "888-709-4485",
            "fax_number": "302-733-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MADISON ST",
            "address_2": "FIRST FLOOR",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043589",
            "telephone_number": "206-386-2323",
            "fax_number": "206-385-6150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 17th Ave Ste A10",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981225789",
            "country_code": "US",
            "telephone_number": "206-320-7130",
            "fax_number": "206-320-7137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TUMOR INSTITUTE RADIATION ONCOLOGY GROUP LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2022-07-05",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "MONAHAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "206-320-7129"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805203",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-PALMETTO GBA",
            "identifier": "CS0846",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.