Active NPI
Robert A. Brezak, MD
- Diagnostic Radiology Physician
- Tacoma, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD60367833
- Practice address
- 1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900 - Phone
- (253) 761-4200
- NPI assigned
- Apr 18, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | 60367833 | WA | |
| Diagnostic Radiology Physician | 2085R0202X | MD205146 | OR | |
| Diagnostic Radiology Physician | 2085R0202X | MD60367833 | WA | Primary |
Addresses
Primary practice location
1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Mailing address
1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone (253) 761-4200
Other practice location 1
19020 33rd Ave W
Suite 210
Lynnwood, WA 98036-4746
Phone (425) 563-1500
Other practice location 2
930 SW Abbey St
Newport, OR 97365-4820
Phone (541) 265-2244
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 340866 | Other | WA | LNI PROVIDER ID |
| 2029135 | Medicaid | WA | |
| 340865 | Other | WA | LNI PROVIDER ID |
| 1386818516 | Medicaid | WA | |
| 340864 | Other | WA | LNI PROVIDER ID |
| 340867 | Other | WA | LNI PROVIDER ID |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rbrezakcontractstaff216202@samhealth.direct-ci.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- New York Medical College, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6910 160TH St SW
Edmonds, WA 98026-4537
Phone (253) 841-4353
Hospital & facility affiliations
- Tacoma General Allenmore Hospital
- Multicare Good Samaritan Hospital
- St Joseph Medical Center
- St Anthony Hospital
- St Clare Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60367833 | WA | MD | Body Imaging Physician |
| MD205146 | OR | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance | Current | Accepting new patients | |
| Radia Imaging Center Holdings LLC | Diagnostic Radiology | Current | Accepting new patients |
| Tra Medical Imaging Centers LLC | Current | Accepting new patients | |
| Tra-Minw P S | Current | Accepting new patients | |
| Swedish Radia Imaging Center at Edmonds LLC | Diagnostic Radiology | Current | Accepting new patients |
| Evergreen Radia LLC | Diagnostic Radiology | Current | Accepting new patients |
| Union Avenue Open MRI LLC | Current | Accepting new patients |
Locations
21700 Highway 99
Edmonds, WA 98026
Phone (425) 640-4949
13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700
34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100
11521 NE 128th St
Ste 200
Kirkland, WA 98034
Phone (425) 952-6100
19020 33rd Ave W
Ste 210
Lynnwood, WA 98036
Phone 42556315001
1025 153rd St SE
Ste 200
Mill Creek, WA 98012
Phone (425) 338-4000
3417 Ensign Rd NE
Olympia, WA 98506
Phone (360) 493-4600
222 15th Ave SE
Puyallup, WA 98372
18100 NE Union Hill Rd
Redmond, WA 98052
Phone (425) 498-2020
1229 Madison St
Ste 900
Seattle, WA 98104
Phone (206) 292-6233
1221 Madison St
Ste 150
Seattle, WA 98104
Phone (206) 215-6433
500 17th Ave
Seattle, WA 98122
Phone (206) 320-2111
3402 S 18th St
Tacoma, WA 98405
Phone (253) 383-1099
1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372
2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900
4816 NE Thurston Way
Ste A
Vancouver, WA 98662
Phone (360) 254-4914
Interoperability endpoints
- https://app.meldrx.com/api/fhir/ei-trami
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.
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1083802946
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1396814166
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1568531242
-
- Diagnostic Radiology Physician
- Kirkland, WA
- NPI 1922095694
-
- Diagnostic Radiology Physician
- Seattle, WA
- NPI 1639653017
-
- Diagnostic Radiology Physician
- Edmonds, WA
- NPI 1164494373
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1447041751
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1124291117
-
- General Acute Care Hospital
- Gig Harbor, WA
- NPI 1447406699
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1952309098
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1366556227
-
- General Acute Care Hospital
- Puyallup, WA
- NPI 1841231461
-
- General Acute Care Hospital
- Lakewood, WA
- NPI 1689672693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724889600000",
"number": "1386818516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1304 FAWCETT AVE STE 100",
"city": "TACOMA",
"state": "WA",
"postal_code": "984021900",
"telephone_number": "253-761-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 FAWCETT AVE STE 100",
"city": "TACOMA",
"state": "WA",
"postal_code": "984021900",
"telephone_number": "253-761-4200"
}
],
"practiceLocations": [
{
"address_1": "19020 33rd Ave W",
"address_2": "Suite 210",
"address_purpose": "LOCATION",
"city": "Lynnwood",
"state": "WA",
"postal_code": "980364746",
"country_code": "US",
"telephone_number": "425-563-1500",
"fax_number": "425-563-1501",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "930 SW Abbey St",
"address_purpose": "LOCATION",
"city": "Newport",
"state": "OR",
"postal_code": "973654820",
"country_code": "US",
"telephone_number": "541-265-2244",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BREZAK",
"first_name": "ROBERT",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-18",
"last_updated": "2024-08-29",
"certification_date": "2024-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "WA",
"license": "60367833",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OR",
"license": "MD205146",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "MD60367833",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LNI PROVIDER ID",
"identifier": "340866",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2029135",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LNI PROVIDER ID",
"identifier": "340865",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1386818516",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LNI PROVIDER ID",
"identifier": "340864",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LNI PROVIDER ID",
"identifier": "340867",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rbrezakcontractstaff216202@samhealth.direct-ci.com",
"affiliation": "N",
"address_1": "930 SW Abbey St",
"city": "Newport",
"state": "OR",
"country_code": "US",
"postal_code": "973654820",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.