NPIMap

Individual provider Active NPI

Blaine Menon

  • Vascular & Interventional Radiology Physician
  • Tacoma, WA
National Provider Identifier
1508328113
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD61631944 Issued in WA
Practice address
1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone
(253) 761-4200
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM
Vascular & Interventional Radiology Physician 2085R0204X MD61631944 WA Primary

Addresses

Primary practice location

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900

Mailing address

Uw Office of Gme 1959 NE Pacific St
Seattle, WA 98195-0001

Other practice location 1

Msc Medicine 1 University Of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-4661

Other practice location 2

Uw Office Of Gme 1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 543-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250609002265 WA Practitioner - Interventional Radiology 0446587570 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tra-Minw P SGroup PAC ID 2163316167, 152 clinicians

Practice addresses (Care Compare)

222 15TH Ave SE
Puyallup, WA 98372-3754
Phone (253) 841-4353

2502 S Union Ave
Tacoma, WA 98405-1328
Phone (253) 841-4353

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tra Medical Imaging Centers LLC CurrentSince Dec 1, 2025 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Jun 1, 2025 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Jun 1, 2025 Accepting new patients
Tra-Minw P S CurrentSince Jun 1, 2025 Accepting new patients
Tra-Minw P S Past Accepting new patients

Locations

122 3rd St NE
Auburn, WA 98002
Phone (253) 833-7750

21110 Sr 410 E
Ste 110
Bonney Lake, WA 98391

5900 State Highway 303 NE
Bremerton, WA 98311
Phone (253) 459-6633

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

4700 Point Fosdick Dr
Ste 110
Gig Harbor, WA 98335
Phone (253) 759-2622

500 Lilly Rd NE
Ste 160
Olympia, WA 98506
Phone (360) 413-8307

222 15th Ave SE
Puyallup, WA 98372

11212 Sunrise Blvd E
Ste 200
Puyallup, WA 98374

3400 California Ave SW
Seattle, WA 98116
Phone (206) 320-3399

5919 100th St SW
Tacoma, WA 98499

2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900

3402 S 18th St
Tacoma, WA 98405
Phone (253) 383-1099

1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ei-trami

Organizations & group practices 5

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 10

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1508328113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UW OFFICE OF GME 1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001"
        },
        {
            "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": "Msc Medicine 1 University Of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-4661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Uw Office Of Gme 1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-543-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENON",
        "first_name": "BLAINE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD61631944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.