NPIMap

Individual provider Active NPI

Casey Ray Medina, MD

  • Diagnostic Radiology Physician
  • Mount Vernon, WA
National Provider Identifier
1609304070
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD61282818 Issued in WA
Practice address
125 N 18TH St Ste C
Mount Vernon, WA 98273-3902
Phone
(360) 424-6161
NPI assigned
May 31, 2017
Last updated
Apr 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10060352 TX
Diagnostic Radiology Physician 2085R0202X MD61282818 WA Primary

Addresses

Primary practice location

125 N 18TH St Ste C
Mount Vernon, WA 98273-3902

Mailing address

8100 Cambridge St Apt 131
Houston, TX 77054-3164
Phone (253) 230-2066

Other practice location 1

1 Baylor Plz
Houston, TX 77030-3411
Phone (253) 230-2066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230427001090 WA Practitioner - Diagnostic Radiology 1153743992 Reassigns benefits to 9 organizations
I20230512001639 AK Practitioner - Diagnostic Radiology 1153743992 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Baylor College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairbanks Medical Imaging LLCGroup PAC ID 4082894407, 28 clinicians
Skagit Radiology Inc P SGroup PAC ID 7113815218, 39 clinicians
North Star Medical Imaging PLLCGroup PAC ID 7214005099, 30 clinicians
Skagit Digital Imaging LLCGroup PAC ID 4486543204, 29 clinicians
Bellingham Advanced Medical Imaging LLCGroup PAC ID 9739446824, 27 clinicians

Practice addresses (Care Compare)

101 N Main St
Coupeville, WA 98239-3413

1211 24TH St
Anacortes, WA 98221-2562
Phone (360) 678-5151

1218 147TH PL SW
Lynnwood, WA 98087-6055
Phone (360) 678-5151

1320 E Division St
Mount Vernon, WA 98274-4133
Phone (360) 424-6161

1344 King St
Suite 101
Bellingham, WA 98229-6215
Phone (360) 424-6161

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 424-6161

2310 Peger Rd
Suite 102
Fairbanks, AK 99709-5305
Phone (360) 424-6161

330 S Stillaguamish Ave
Arlington, WA 98223-1642
Phone (360) 424-6161

3822 Colby Ave
Suite 100
Everett, WA 98201-4913
Phone (360) 424-6161

834 Sheridan St
Port Townsend, WA 98368-2443
Phone (360) 385-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10060352TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Star Medical Imaging PLLC Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
Alliance Healthcare Services Inc CurrentSince Jan 1, 2024 Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince Jun 30, 2023 Accepting new patients
Iliuliuk Family and Health Services Inc CurrentSince Aug 19, 2023 Accepting new patients
Whidbey Island Public Hospital District CurrentSince Jul 3, 2023 Accepting new patients
Fairbanks Medical Imaging LLC Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
Whidbey Island Public Hospital District CurrentSince Jul 3, 2023 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Jun 28, 2024 Accepting new patients
Bellingham Advanced Medical Imaging LLC Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince Jun 30, 2023 Accepting new patients
Skagit Radiology Inc P S Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
Iliuliuk Family &Health Services, Inc. Past Accepting new patients

Locations

2310 Peger Rd
Ste 102
Fairbanks, AK 99709

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

1344 King St
Ste 101
Bellingham, WA 98229
Phone (360) 676-6393

101 N Main St
Coupeville, WA 98239
Phone (360) 678-7656

125 N 18th St
Ste C
Mount Vernon, WA 98273
Phone (360) 428-7274

1320 E Division St
Mount Vernon, WA 98274
Phone (360) 424-9607

1415 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 416-5750

1200 W Sims Way
Ste C
Port Townsend, WA 98368
Phone (360) 385-6297

834 Sheridan St
Port Townsend, WA 98368
Phone (360) 344-0400

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1609304070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 CAMBRIDGE ST APT 131",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770543164",
            "telephone_number": "253-230-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N 18TH ST STE C",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982733902",
            "telephone_number": "360-424-6161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Baylor Plz",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770303411",
            "country_code": "US",
            "telephone_number": "253-230-2066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "CASEY",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-31",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10060352",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD61282818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.