Individual provider Active NPI

Mark J Roggeveen, M.D.

  • Diagnostic Radiology Physician
  • Federal Way, WA
National Provider Identifier
1609975416
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A94934 Issued in CA
Practice address
533 S 336TH St
Suite C
Federal Way, WA 98003-6329
Phone
(253) 661-1700
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A94934 CA Primary

Addresses

Primary practice location

533 S 336TH St
Suite C
Federal Way, WA 98003-6329

Mailing address

533 S 336TH St
Suite C
Federal Way, WA 98003-6329

Other identifiers 1

IdentifierTypeStateIssuer
8475451MedicaidWA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070709000323 WA Practitioner - Diagnostic Radiology 6800893371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Columbia University College of Physicians and Surgeons, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1405 Dexter Ave N
Unit 709
Seattle, WA 98109-6139
Phone (253) 661-1700

1615 Killarney Way
Bellevue, WA 98004-7050
Phone (253) 661-1700

1819 203Rd Ave SE
Sammamish, WA 98075-9681
Phone (253) 661-1700

400 S 43Rd St
Valley Medical Center
Renton, WA 98055-5714
Phone (425) 656-5550

416 W Newell St
Seattle, WA 98119-2360
Phone (253) 661-1700

Hospital & facility affiliations

  • Valley Medical Center Hospital, Renton, WA, CCN 500088
  • Multicare Auburn Medical Center Hospital, Auburn, WA, CCN 500015
  • Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Radiology & Diagnostic Services, a Professional Services Corp Diagnostic Radiology CurrentSince Aug 1, 2007 Accepting new patients

Locations

533 S 336th St
Ste C
Federal Way, WA 98003
Phone (253) 661-4755

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

Organizations & group practices 1

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 5

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1609975416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 S 336TH ST",
            "address_2": "SUITE C",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 S 336TH ST",
            "address_2": "SUITE C",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036329",
            "telephone_number": "253-661-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGGEVEEN",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A94934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8475451",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.