NPIMap

Individual provider Active NPI

Joanne S. Chua, M.D.

  • Diagnostic Radiology Physician
  • Lynnwood, WA
National Provider Identifier
1679787311
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD60207514 Issued in WA
Practice address
19020 33Rd Ave W
Suite 210
Lynnwood, WA 98036-4748
Phone
(425) 563-1500
Fax
(425) 563-1501
NPI assigned
May 10, 2007
Last updated
Apr 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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 MT188427 PA
Diagnostic Radiology Physician 2085R0202X MD60207514 WA Primary

Addresses

Primary practice location

19020 33Rd Ave W
Suite 210
Lynnwood, WA 98036-4748

Mailing address

19020 33Rd Ave W
Suite 210
Lynnwood, WA 98036-4748
Phone (425) 563-1500

Other identifiers 1

IdentifierTypeStateIssuer
2012737MedicaidWA

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
I20110906000088 WA Practitioner - Diagnostic Radiology 3870763642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4033 Talbot Rd S
Renton, WA 98055-5700
Phone (425) 656-5588

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT188427PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Radiology & Diagnostic Services, a Professional Services Corp Diagnostic Radiology CurrentSince Jul 30, 2012 Accepting new patients
Imaging Partners at Valley LLC Diagnostic Radiology Past Accepting new patients
Empire Health Services Past Accepting new patients
King County Public Hospital District No. 2 Past Accepting new patients
Multicare Health System Past Accepting new patients
Radia Inc P S Diagnostic Radiology Past Accepting new patients

Locations

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

Organizations & group practices 6

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 4

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1679787311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W",
            "address_2": "SUITE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W",
            "address_2": "SUITE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "JOANNE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT188427",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60207514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2012737",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.