Individual provider Active NPI

Kevin Eugene Sanders, MD

  • Radiation Oncology Physician
  • Puyallup, WA
National Provider Identifier
1376554154
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD00046461 Issued in WA
Practice address
2940 S Meridian Ste 100
Puyallup, WA 98373-1659
Phone
(253) 200-3166
Fax
(253) 200-3167
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X MD00046461 WA Primary

Addresses

Primary practice location

2940 S Meridian Ste 100
Puyallup, WA 98373-1659

Mailing address

2920 S Meridian Ste 200
Puyallup, WA 98373-1428
Phone (532) 200-3166

Other identifiers 1

IdentifierTypeStateIssuer
9180009MedicaidWA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061211000514 WA Practitioner - Radiation Oncology 3870592371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Cancer Care PLLCGroup PAC ID 9739443391, 2 clinicians

Practice addresses (Care Compare)

2940 S Meridian
Suite 100
Puyallup, WA 98373-1659
Phone (253) 200-3166

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Cancer Care PLLC Radiation Oncology CurrentSince Jun 15, 2018 Accepting new patients
Sound Cancer Care PLLC Current Accepting new patients
Riverside Oncology PC Radiation Oncology Current Accepting new patients
Universal Treatment Center, Inc Past Accepting new patients

Locations

2940 S Meridian
Puyallup, WA 98373
Phone (253) 200-3166

2920 S Meridian
Ste 200
Puyallup, WA 98373
Phone (253) 200-3166

2940 S Meridian
Ste 100
Puyallup, WA 98373
Phone (253) 200-3166

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1376554154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 S MERIDIAN STE 200",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983731428",
            "telephone_number": "532-200-3166",
            "fax_number": "253-200-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 S MERIDIAN STE 100",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983731659",
            "telephone_number": "253-200-3166",
            "fax_number": "253-200-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KEVIN",
        "middle_name": "EUGENE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "MD00046461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9180009",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.