Evergreen Radia LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

602317167 Issued in WA

Legal business name

EVERGREEN RADIA LLC

Practice address

11521 NE 128TH St
Suite 200
Kirkland, WA 98034-4317

Phone

(425) 952-6100

Fax

(425) 952-6150

NPI assigned

Sep 28, 2005

Organization subpart

No

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

Authorized official

Name

Lloyd Stambaugh, MDNPI 1568440089

Title

President

Phone

(425) 563-1500

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Evergreen Radia Doing business as

Medicare fee-for-service enrollment

Enrolled in WA, CA, HI, UT, VA, AZ, OR, FL, MA, TX, GA, NE, MI, MO, DC, AL, NC, NV, PA, IA, ID, SC, CO, CT, MD, OK, OH, TN, IL, ME, MT, NJ, AK33 enrollments

Enrollment records 33

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Public Hospital District No 2

  • Family Medicine Physician
  • Redmond, WA
  • NPI 1578653747

  Member Of

  NPD member

Locations

Practitioners 329

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lloyd Edwin Stambaugh III, MD

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1568440089
  Medicare reassignment Care Compare group NPD Authorized official
• David Alan Alexander, MD

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1538202528
  Medicare reassignment Care Compare group NPD
• Zachary Robert Ashwell, MD

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1396189445
  Medicare reassignment Care Compare group NPD
• Benis P. Babusis, MD

  • Body Imaging Physician
  • Lynnwood, WA
  • NPI 1669450979

  Diagnostic Radiology, UT

  Medicare reassignment Care Compare group NPD
• Keith Aaron Bernstein, MD

  • Neuroradiology Physician
  • Vancouver, WA
  • NPI 1760446306

  CA, Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Varun Srinivas Bhandarkar, MD

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1790041911
  Medicare reassignment Care Compare group NPD
• William J Brinkman, MD

  • Diagnostic Radiology Physician
  • Vancouver, WA
  • NPI 1932162518
  Medicare reassignment Care Compare group NPD
• Ian Yen CH'En, MD

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1174527121
  Medicare reassignment Care Compare group NPD
• Herbert W. Chen, M.D.

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1720038078
  Medicare reassignment Care Compare group NPD
• Maria Chong, MD

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1295712396
  Medicare reassignment Care Compare group NPD
• William C Feldmann, M.D.

  • Diagnostic Radiology Physician
  • Yakima, WA
  • NPI 1063433563
  Medicare reassignment Care Compare group NPD
• Jack Mark Fields, MD

  • Diagnostic Radiology Physician
  • Olympia, WA
  • NPI 1326016379
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1127865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536710400000",
    "number": "1922095694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11521 NE 128TH ST",
            "address_2": "SUITE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980344317",
            "telephone_number": "425-952-6100",
            "fax_number": "425-952-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN RADIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-28",
        "last_updated": "2018-09-12",
        "status": "A",
        "authorized_official_last_name": "STAMBAUGH",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-563-1500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "602317167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7118227",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP LABOR & INDUSTRIES",
            "identifier": "175238",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP CRIME VICTIMS",
            "identifier": "8933574",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Radia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evergreen Radia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evergreen Healthcare
• Evergreen in Home Mental Health
• Evergreen Medical Center Anesthesiology Services PS
• Evergreen Neurology Clinic, PLLC
• Evergreen Pediatrics PLLC
• Evergreen Surgery Center, LLC
• Evergreen Telepsychiatry PLLC
• Evergreen Urology Assoc Inc PS
• Evergreen Women'S Care, PLLC
• Evergreen Women'S Health Center PLLC

• Diagnostic Radiology Physician in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Diagnostic Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.