Individual provider Active NPI

Nathan Bittner, MD

  • Radiation Oncology Physician
  • Puyallup, WA
National Provider Identifier
1609989714
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ML20007539 Issued in WA
Practice address
400 15TH Ave SE Ste a
Puyallup, WA 98372-3750
Phone
(253) 841-4311
Fax
(253) 627-8792
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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 ML20007539 WA Primary

Addresses

Primary practice location

400 15TH Ave SE Ste a
Puyallup, WA 98372-3750

Mailing address

4230 Bridgeport Way W Ste B
University Place, WA 98466-4335
Phone (253) 779-6325

Other identifiers 3

IdentifierTypeStateIssuer
MD60006974OtherWAMD LICENSE
11839467OtherCAQH
7058480MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tacomaradiation@directaddress.net Direct

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
I20080904000759 WA Practitioner - Radiation Oncology 1759457336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Washington School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peninsula Rad Onc Ctr LLCGroup PAC ID 6204990450, 5 clinicians
Tacoma Radiation Oncology Center Inc, PSGroup PAC ID 1658260302, 6 clinicians

Practice addresses (Care Compare)

11511 Canterwood Blvd
Suite 50
Gig Harbor, WA 98332-5816
Phone (253) 851-5155

400 15TH Ave SE
Suite a
Puyallup, WA 98372-3750
Phone (253) 841-4311

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML20007539WAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Rad Onc Ctr LLC Radiation Oncology CurrentSince Jun 19, 2020 Accepting new patients

Locations

11511 Canterwood Blvd
Ste 50
Gig Harbor, WA 98332
Phone (253) 530-2939

1900 NW Myhre Rd
Silverdale, WA 98383
Phone (564) 240-3100

314 Martin Luther King Jr Way
Ste 11
Tacoma, WA 98405
Phone (253) 627-6172

4230 Bridgeport Way W
Ste B
University Place, WA 98466
Phone (253) 272-1077

Interoperability endpoints

  • Direct secure messaging: tacomaradiation@directaddress.net

Organizations & group practices 2

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1609989714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 BRIDGEPORT WAY W STE B",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664335",
            "telephone_number": "253-779-6325",
            "fax_number": "253-627-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 15TH AVE SE STE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723750",
            "telephone_number": "253-841-4311",
            "fax_number": "253-627-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BITTNER",
        "first_name": "NATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "ML20007539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "MD60006974",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11839467",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7058480",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tacomaradiation@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "CCDA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "400 15th Ave SE Ste A",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983723750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.