Individual provider Active NPI

George Tian-Yi Wang, M.D.

  • Diagnostic Radiology Physician
  • Tacoma, WA
National Provider Identifier
1275658734
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD60071506 Issued in WA
Practice address
1304 Fawcett Ave
Suite 100
Tacoma, WA 98402-1911
Phone
(253) 761-4200
Fax
(253) 383-3553
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X 4301083789 MI
Diagnostic Radiology Physician 2085R0202X 200800524 NC
Student in an Organized Health Care Education/Training Program 390200000X 4301083789 MI
Diagnostic Radiology Physician 2085R0202X MD60071506 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 1

IdentifierTypeStateIssuer
G8882905OtherWAPTAN-UAOM

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090813000624 WA Practitioner - Diagnostic Radiology 0749380129 Reassigns benefits to 3 organizations
I20130520000717 OR Practitioner - Diagnostic Radiology 0749380129 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200800524NCMDDiagnostic Radiology Physician
MD60071506WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Avenue Open MRI LLC CurrentSince Jun 28, 2009 Accepting new patients
Tra-Minw, PS Diagnostic Radiology CurrentSince Apr 15, 2013 Accepting new patients
Tra-Minw P S CurrentSince Jun 1, 2009 Accepting new 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
Tra-Minw P S CurrentSince Jun 1, 2009 Accepting new patients
Burlington Radiological Associates Diagnostic Neuroimaging Past Accepting new patients

Locations

2801 St Anthony Way
Pendleton, OR 97801
Phone (541) 276-5121

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

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

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

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

3021 Griffin Ave
Enumclaw, WA 98022
Phone (253) 833-6241

1455 Battersby Ave
Enumclaw, WA 98022
Phone (253) 552-5615

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

33915 1st Way S
Ste 130
Federal Way, WA 98003
Phone (253) 528-9135

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

9725 SE 36th St
Ste 114
Mercer Island, WA 98040

222 15th Ave SE
Puyallup, WA 98372

3400 California Ave SW
Seattle, WA 98116
Phone (206) 320-3399

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

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

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

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

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

2209 E 32nd St
Tacoma, WA 98404
Phone (206) 593-0244

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

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

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

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1275658734",
    "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": "WANG",
        "first_name": "GEORGE",
        "middle_name": "TIAN-YI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "MI",
            "license": "4301083789",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200800524",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301083789",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60071506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN-UAOM",
            "identifier": "G8882905",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.