NPIMap

Individual provider Active NPI

Gregory W Allen, M.D., PHD

  • Radiation Oncology Physician
  • Lacey, WA
National Provider Identifier
1508817404
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD00047784 Issued in WA
Practice address
4525 3Rd Ave SE
Suite 100
Lacey, WA 98503-1010
Phone
(360) 412-8960
Fax
(360) 412-8970
NPI assigned
May 15, 2006
Last updated
Mar 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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 MD00047784 WA Primary

Addresses

Primary practice location

4525 3Rd Ave SE
Suite 100
Lacey, WA 98503-1010

Mailing address

4525 3Rd Ave SE
Suite 100
Lacey, WA 98503-1010
Phone (360) 412-8960

Other identifiers 2

IdentifierTypeStateIssuer
8503872MedicaidWA
1508817404OtherNPI

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
I20080528000592 WA Practitioner - Radiation Oncology 3870663230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Loma Linda University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiantcare Physicians PLLCGroup PAC ID 6608869581, 5 clinicians

Practice addresses (Care Compare)

4525 3Rd Ave SE
Suite 100
Lacey, WA 98503-1010
Phone (360) 412-8960

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00047784WAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Past Accepting new patients
Providence Health & Services Washington PastSince Jan 28, 2008 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1508817404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 3RD AVE SE",
            "address_2": "SUITE 100",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031010",
            "telephone_number": "360-412-8960",
            "fax_number": "360-412-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 3RD AVE SE",
            "address_2": "SUITE 100",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031010",
            "telephone_number": "360-412-8960",
            "fax_number": "360-412-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "GREGORY",
        "middle_name": "W",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "MD00047784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8503872",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1508817404",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.