Individual provider Active NPI

Samuel Beaujean

  • Diagnostic Radiology Physician
  • Seattle, WA
National Provider Identifier
1962039552
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD61665961 Issued in WA
Practice address
1959 NE Pacific St Main Hospital
Seattle, WA 98195-2190
Phone
(206) 598-3300
NPI assigned
Mar 24, 2020
Last updated
Mar 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD61665961 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1959 NE Pacific St Main Hospital
Seattle, WA 98195-2190

Mailing address

75 N Country Rd
Port Jefferson, NY 11777-2190
Phone (631) 686-2549

Other practice location 1

1304 Fawcett Ave
Tacoma, WA 98402-1911
Phone (253) 761-4200

Other practice location 2

75 N Country Rd
Port Jefferson, NY 11777-2190
Phone (631) 686-2549

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
I20260403002067 WA Practitioner - Diagnostic Radiology 1254824295 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1304 Fawcett Ave
Suite 100
Tacoma, WA 98402-1905

2 Meridian Blvd
FL 3
Wyomissing, PA 19610-3202

PO Box
Suite 1535
Tacoma, WA 98401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD61665961WAMDDiagnostic Radiology Physician

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1962039552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772190",
            "telephone_number": "631-686-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST MAIN HOSPITAL",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981952190",
            "telephone_number": "206-598-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 Fawcett Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984021911",
            "country_code": "US",
            "telephone_number": "253-761-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 N Country Rd",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772190",
            "country_code": "US",
            "telephone_number": "631-686-2549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAUJEAN",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD61665961",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.