NPIMap

Organization Active NPI

Peninsula Medical Imaging, PLLC

  • Radiology Clinic/Center
  • Sequim, WA
National Provider Identifier
1356416705
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
MD00029650 Issued in WA
Legal business name
PENINSULA MEDICAL IMAGING, PLLC
Practice address
675 N. Fifth Ave
Suite 2B
Sequim, WA 98382-3201
Phone
(360) 582-0590
Fax
(360) 582-0172
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Authorized official

Name
Dr. Michael Scot Fishman, M.D.NPI 1003015553
Title
Owner
Phone
(360) 582-0590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X MD00029650 WA Primary

Addresses

Primary practice location

675 N. Fifth Ave
Suite 2B
Sequim, WA 98382-3201

Mailing address

PO Box 24322
Seattle, WA 98124-0322
Phone (360) 582-0590

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1356416705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24322",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981240322",
            "telephone_number": "360-582-0590",
            "fax_number": "360-582-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N. FIFTH AVE",
            "address_2": "SUITE 2B",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823201",
            "telephone_number": "360-582-0590",
            "fax_number": "360-582-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA MEDICAL IMAGING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "FISHMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SCOT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-582-0590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "WA",
            "license": "MD00029650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sequim, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.