NPIMap

Organization Active NPI

Tra-Minw, PS

  • Diagnostic Radiology Physician
  • Pendleton, OR
National Provider Identifier
1588904338
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
TRA-MINW, PS
Practice address
1601 SE Court Ave
Department of Radiology
Pendleton, OR 97801-3217
Phone
(253) 761-4200
Fax
(253) 383-0730
NPI assigned
Feb 14, 2013
Last updated
Dec 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Authorized official

Name
Victoria Epshteyn
Title
Director of Finance
Phone
(253) 761-4200

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X
Neuroradiology Physician 2085N0700X
Pediatric Radiology Physician 2085P0229X
Diagnostic Radiology Physician 2085R0202X Primary
Vascular & Interventional Radiology Physician 2085R0204X
Diagnostic Ultrasound Physician 2085U0001X

Addresses

Primary practice location

1601 SE Court Ave
Department of Radiology
Pendleton, OR 97801-3217

Mailing address

PO Box 3656
Seattle, WA 98124-3656
Phone (866) 231-9211

Other identifiers 1

IdentifierTypeStateIssuer
500663945MedicaidOR

Other names 1

  • Tacoma Radiological Associates, P.S. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130506000178 OR Part B Supplier - Clinic/Group Practice 2163316167 Receives reassigned benefits from 32 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Pendleton, OR; Manzanita, OR; Lake Oswego, OR; Corvallis, OR; Bend, OR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671753600000",
    "number": "1588904338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3656",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243656",
            "telephone_number": "866-231-9211",
            "fax_number": "800-508-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SE COURT AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013217",
            "telephone_number": "253-761-4200",
            "fax_number": "253-383-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRA-MINW, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-14",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A",
        "authorized_official_last_name": "EPSHTEYN",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "253-761-4200"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500663945",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tacoma Radiological Associates, P.S.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.