Samuel Beaujean
Individual provider Active NPI Diagnostic Radiology Physician · Seattle, WA
NPI 1962039552 · NPPES record last updated Mar 19, 2026
Key facts
- NPI
- 1962039552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- MD61665961 (WA)
- Practice address
- 1959 NE Pacific St Main Hospital
Seattle, WA 98195-2190 - Phone
- (206) 598-3300
- NPI assigned
- Mar 24, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260403002067 | WA | Practitioner - Diagnostic Radiology | 1254824295 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61665961 | WA | MD | Diagnostic Radiology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD61665961 | WA | Yes |
| 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
75 N Country Rd
Port Jefferson, NY 11777-2190
Phone (631) 686-2549
Other practice location 2
1304 Fawcett Ave
Tacoma, WA 98402-1911
Phone (253) 761-4200
Other providers in Seattle, WA
- Norman Joseph Beauchamp
- Nancy Jean Beaudet
- Tania G Beaudet
- David C Beaudry
- Kristi Kay Beaughan
- Diana Beaulaurier
- Alexa Beaulieu
- Beauty N Kurves LLC
- Patrick Joseph Beauzile-Louyerture
- Cindy Crystal Beavon
All providers in Seattle, WA · Diagnostic Radiology Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.