Individual provider Active NPI

John J Travaglini II, M.D.

  • Radiation Oncology Physician
  • Renton, WA
National Provider Identifier
1902820095
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD00020038 Issued in WA
Practice address
400 South 43Rd
C/O Valley Radiation Oncology
Renton, WA 98055
Phone
(425) 251-5121
Fax
(425) 656-4072
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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 MD00020038 WA Primary

Addresses

Primary practice location

400 South 43Rd
C/O Valley Radiation Oncology
Renton, WA 98055

Mailing address

PO Box 749730
Los Angeles, CA 90074-9730
Phone (206) 971-0034

Other identifiers 1

IdentifierTypeStateIssuer
1019648MedicaidWA

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
I20041102001103 WA Practitioner - Radiation Oncology 9830151729 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tumor Institute Radiation Oncology Group LLP Radiation Oncology CurrentSince Jul 1, 2000 Accepting new patients
The Polyclinic PLLC CurrentSince Jul 12, 2014 Accepting new patients
The Polyclinic PLLC Current Accepting new patients
The Polyclinic CurrentSince Jul 12, 2014 Accepting new patients
Tirog at Valley PLLC Radiation Oncology Past Accepting new patients

Locations

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

1221 Madison St
Ste 1
Seattle, WA 98104
Phone (206) 215-6251

1145 Broadway
Seattle, WA 98122

1221 Madison St
Ste 150
Seattle, WA 98104
Phone (206) 215-6433

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jtravaglini18222@direct.valleymed.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1902820095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749730",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900749730",
            "telephone_number": "206-971-0034",
            "fax_number": "206-215-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SOUTH 43RD",
            "address_2": "C/O VALLEY RADIATION ONCOLOGY",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98055",
            "telephone_number": "425-251-5121",
            "fax_number": "425-656-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVAGLINI",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "MD00020038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019648",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.