Benjamin Wibonele, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD61666933 Issued in WA

Practice address

104 27TH Ave SE
Puyallup, WA 98374-1145

Phone

(253) 770-9000

Fax

(253) 770-9712

NPI assigned

Apr 29, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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 1

Specialty

Otolaryngology

Education

Morehouse School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Medical Center / Cherry Hill Hospital, Seattle, WA, CCN 500025
• Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment Care Compare group NPD
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463
  NPD
• Proliance Surgeons Inc PS

  • Ambulatory Surgical Clinic/Center
  • Puyallup, WA
  • NPI 1780610220
  NPD
• Proliance Surgeons, Inc., P.S.

  • Orthopaedic Surgery Physician
  • Puyallup, WA
  • NPI 1952399123
  NPD
• Proliance Surgeons, Inc., P.S.

  • Otolaryngology Physician
  • Puyallup, WA
  • NPI 1407223985
  NPD (past)

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

• Multicare Health System

  • General Acute Care Hospital
  • Puyallup, WA
  • NPI 1841231461
  Care Compare affiliation
• Swedish Health Services

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1356496582
  Care Compare affiliation

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1285255448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1205",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983710231",
            "telephone_number": "253-770-9000",
            "fax_number": "253-770-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 27TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983741145",
            "telephone_number": "253-770-9000",
            "fax_number": "253-770-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBONELE",
        "first_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-29",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "WA",
            "license": "MD61666933",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD61666933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2338134",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlan Judith Whitley, DPT
• Stephen John Whitley, DPT
• Shana L Whitney
• Steven Wayne Whiton Jr Jr., HA 40701
• Whole Health Services PLLC
• Timothy C Wical Jr., BSN, DNP, PMHNP-BC
• Wiebe 1 Enterprises LLC
• Chantel Wieber
• Shelby Elizabeth Wiedmann
• Robert Ray Wiggins, DDS

• Otolaryngology Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Otolaryngology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.