NPIMap

Individual provider Active NPI

David N.M.I. Stagnone, M.D.

  • Diagnostic Radiology Physician
  • Olympia, WA
National Provider Identifier
1639150725
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD00036036 Issued in WA
Practice address
3417 Ensign Rd NE
Olympia, WA 98506-5075
Phone
(360) 493-4609
Fax
(360) 493-4603
NPI assigned
Nov 7, 2005
Last updated
Dec 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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 MD00036036 WA Primary

Addresses

Primary practice location

3417 Ensign Rd NE
Olympia, WA 98506-5075

Mailing address

3417 Ensign Rd NE
Olympia, WA 98506-5075
Phone (360) 493-4609

Other identifiers 2

IdentifierTypeStateIssuer
8228942MedicaidWA
G8802103OtherWAMEDICARE PTAN

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
I20040506001622 WA Practitioner - Diagnostic Radiology 6103815014 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of New Mexico School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radia Inc P SGroup PAC ID 9931012812, 275 clinicians
Radia California Radiology Medical Group IncGroup PAC ID 8921465998, 134 clinicians
South Sound Radiologists Inc P SGroup PAC ID 1254229305, 76 clinicians

Practice addresses (Care Compare)

12040 NE 128TH St
Kirkland, WA 98034-3013
Phone (425) 899-1800

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 563-1500

3417 Ensign Rd NE
Olympia, WA 98506-5064
Phone (360) 493-4600

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00036036WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Radia Imaging Center Holdings LLC Diagnostic Radiology CurrentSince Jan 1, 2019 Accepting new patients
Swedish Radia Imaging Center at Edmonds LLC Diagnostic Radiology CurrentSince Sep 18, 2019 Accepting new patients
Radia Imaging Center Holdings LLC Diagnostic Radiology CurrentSince Jan 1, 2019 Accepting new patients
Radia California Radiology Medical Group Inc Diagnostic Radiology CurrentSince Feb 21, 2024 Accepting new patients
Central Washington Health Services Association Current Accepting new patients
Central Washington Health Services Association CurrentSince Jul 1, 2023 Accepting new patients
Evergreen Radia LLC Diagnostic Radiology CurrentSince Sep 18, 2019 Accepting new patients
Radia Inc P S Diagnostic Radiology CurrentSince Jan 1, 2018 Accepting new patients
South Sound Radiology Aberdeen LLC Diagnostic Radiology Past Accepting new patients
Olympia Radiologists, P.S. Diagnostic Radiology PastSince May 1, 1997 Accepting new patients

Locations

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

19950 Rinaldi St
Ste 101B
Porter Ranch, CA 91326
Phone (818) 496-7517

1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

26357 McBean Pkwy
Ste 155
Santa Clarita, CA 91355
Phone (661) 288-5940

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

121 Sotoyome St
Santa Rosa, CA 95405
Phone (707) 546-3141

925 Corporate Cntr Pkwy
Ste A
Santa Rosa, CA 95407
Phone (707) 543-2000

6580 Hembree Ln
Ste 270
Windsor, CA 95492
Phone (707) 838-2044

21700 Highway 99
Edmonds, WA 98026
Phone (425) 640-4949

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

11521 NE 128th St
Ste 200
Kirkland, WA 98034
Phone (425) 952-6100

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

19020 33rd Ave W
Ste 210
Lynnwood, WA 98036
Phone 42556315001

1025 153rd St SE
Ste 200
Mill Creek, WA 98012
Phone (425) 338-4000

3417 Ensign Rd NE
Olympia, WA 98506
Phone (360) 493-4600

1229 Madison St
Ste 900
Seattle, WA 98104
Phone (206) 292-6233

500 17th Ave
Seattle, WA 98122
Phone (206) 320-2111

550 17th Ave
Ste 630
Seattle, WA 98122
Phone (206) 320-2158

4816 NE Thurston Way
Ste A
Vancouver, WA 98662
Phone (360) 254-4914

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

Organizations & group practices 12

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 12

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1639150725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 ENSIGN RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065075",
            "telephone_number": "360-493-4609",
            "fax_number": "360-493-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 ENSIGN RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065075",
            "telephone_number": "360-493-4609",
            "fax_number": "360-493-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGNONE",
        "first_name": "DAVID",
        "middle_name": "N.M.I.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00036036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8228942",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8802103",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.