Active NPI
Justin Bradley Smith, MD
- Vascular & Interventional Radiology Physician
- Lynnwood, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- MD60299983
- Practice address
- 19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748 - Phone
- (425) 563-1500
- Fax
- (425) 563-1501
- NPI assigned
- Jun 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | M-12706 | ID | |
| Diagnostic Radiology Physician | 2085R0202X | MD60299983 | WA | |
| Vascular & Interventional Radiology Physician | 2085R0204X | M-12706 | ID | |
| Vascular & Interventional Radiology Physician | 2085R0204X | MD60299983 | WA | Primary |
Addresses
Primary practice location
19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Mailing address
19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Phone (425) 563-1500
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0345196 | Other | WA | L&I-RADIA REST OF WA |
| 2020382 | Medicaid | WA | |
| 0345197 | Other | WA | L&I-RADIA KING CTY |
| 0345198 | Other | WA | L&I-SWEDISH RADIA EDMONDS |
| 1306006531 | Medicaid | ID | |
| 0345199 | Other | WA | L&I-EVERGREEN RADIA |
| 0407044 | Other | WA | L&I-SEATTLE RADIOLOGY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Radiology
- Education
- University of Nevada School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13424 E Mission Ave
Spokane Valley, WA 99216-2759
Phone (509) 462-2273
2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8000
311 S L St
Tacoma, WA 98405-3720
4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706
910 W 5TH Ave
Suite 801
Spokane, WA 99204-2974
Phone (509) 755-6760
Hospital & facility affiliations
- Deaconess Medical Center
- Multicare Valley Hospital
- Yakima Valley Memorial
- Samaritan Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60299983 | WA | MD | Vascular & Interventional Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Oncology Associates, PS | Current | Accepting new patients | |
| Yakima Valley Memorial Physicians | Current | Accepting new patients | |
| Medical Oncology Associates, P.S. | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Peak Interventional Radiology, P.L.L.C. | Vascular & Interventional Radiology | Current | Accepting new patients |
| Multicare Health System | Diagnostic Radiology | Current | Accepting new patients |
| Multicare Health System | Current | Accepting new patients | |
| Yakima Valley Memorial Physicians | Current | Accepting new patients |
Locations
143 Garden Homes Dr
Colville, WA 99114
Phone (509) 684-3701
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
222 State Ave N
Kent, WA 98030
Phone (253) 372-7680
800 W 5th Ave
Spokane, WA 99204
Phone (509) 458-5800
311 S L St
Tacoma, WA 98405
Phone (253) 403-1444
2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210
Organizations & group practices 10
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.
-
- Specialist
- Spokane, WA
- NPI 1215980198
-
- Neurological Surgery Physician
- Tacoma, WA
- NPI 1497766638
-
- General Acute Care Hospital
- Yakima, WA
- NPI 1306933940
-
- Vascular & Interventional Radiology Physician
- Spokane Valley, WA
- NPI 1124887757
-
- Multi-Specialty Clinic/Center
- Wenatchee, WA
- NPI 1669719688
-
- Radiation Oncology Physician
- Spokane Valley, WA
- NPI 1831524073
-
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1396594875
-
- Diagnostic Radiology Physician
- Covington, WA
- NPI 1578803839
-
- Durable Medical Equipment & Medical Supplies
- Yakima, WA
- NPI 1366325870
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Moses Lake, WA
- NPI 1902818883
-
- General Acute Care Hospital
- Spokane, WA
- NPI 1356528269
-
- General Acute Care Hospital
- Spokane Valley, WA
- NPI 1538345251
-
- General Acute Care Hospital
- Yakima, WA
- NPI 1053373480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709769600000",
"number": "1306006531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19020 33RD AVE W STE 210",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364748",
"telephone_number": "425-563-1500",
"fax_number": "425-563-1374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19020 33RD AVE W STE 210",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364748",
"telephone_number": "425-563-1500",
"fax_number": "425-563-1501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JUSTIN",
"middle_name": "BRADLEY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-11",
"last_updated": "2024-03-07",
"certification_date": "2024-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "ID",
"license": "M-12706",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "MD60299983",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "ID",
"license": "M-12706",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "WA",
"license": "MD60299983",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-RADIA REST OF WA",
"identifier": "0345196",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2020382",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-RADIA KING CTY",
"identifier": "0345197",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-SWEDISH RADIA EDMONDS",
"identifier": "0345198",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306006531",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-EVERGREEN RADIA",
"identifier": "0345199",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-SEATTLE RADIOLOGY",
"identifier": "0407044",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.