Benjamin O. Dy, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00025491 Issued in WA

Practice address

4314 E Portland Ave Ste 7
Tacoma, WA 98404-4696

Phone

(253) 476-9121

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

General Practice

Education

Other, 1965

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portland Avenue Clinic ManagementGroup PAC ID 4789574674, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Portland Avenue Clinic Management

  • Primary Care Clinic/Center
  • Tacoma, WA
  • NPI 1922139534
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1831253368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7116 153RD AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980524297",
            "telephone_number": "206-619-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 E PORTLAND AVE STE 7",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984044696",
            "telephone_number": "253-476-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DY",
        "first_name": "BENJAMIN",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00025491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Dutler
• Joseph Michael Dutner, D.M.D.
• Brenda Joyce Duzan, L.AC
• Amy M Dwyer, LICSW
• Edna Roxana Dwyer, BA IN PSYCH
• Staci Dycus
• George James Dydek, PHARM.D., BCPS,CDCES
• Heather Dyer, RN, BSN
• Lauren Dyke
• Dynamic Imaging Centers LLC

• Family Medicine Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.