Individual provider Active NPI

Patrick O'Brien, MD

  • Diagnostic Radiology Physician
  • Yakima, WA
National Provider Identifier
1992782692
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD23956 Issued in OR
Practice address
315 Holton Ave
Ste 102
Yakima, WA 98902-3254
Phone
(509) 895-0402
Fax
(509) 248-0733
NPI assigned
Dec 23, 2005
Last updated
Oct 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD23956 OR Primary

Addresses

Primary practice location

315 Holton Ave
Ste 102
Yakima, WA 98902-3254

Mailing address

PO Box 2925
Yakima, WA 98907-2925
Phone (509) 895-0402

Other identifiers 4

IdentifierTypeStateIssuer
840126018OtherORREGENCE BS/BC
268491MedicaidOR
8323032MedicaidWA
P00203830OtherORRR MC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20040423000345 OR Practitioner - Diagnostic Radiology 1850387952 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23956ORMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Imaging PC Diagnostic Radiology CurrentSince Jan 1, 2016 Accepting new patients
Valley Imaging Past Accepting new patients
Advanced Medical Imaging Center LLC Diagnostic Radiology Past Accepting new patients
Northwest Imaging, PC Diagnostic Radiology Past Accepting new patients
Epic Imaging-West, Inc. Diagnostic Radiology PastSince Jan 1, 2016 Accepting new patients
Anesthesia Associates Northwest LLC PastSince Jan 1, 2016 Accepting new patients
Radiology Specialists of the Northwest, PC Diagnostic Radiology PastSince Aug 1, 2015 Accepting new patients
Portland Medical Imaging LLC Diagnostic Radiology Past Accepting new patients

Locations

5775 Wayzata Blvd
Ste 400
St Louis Park, MN 55416
Phone (952) 525-6338

1500 NW Bethany Blvd
Ste 100
Beaverton, OR 97006
Phone (503) 619-1100

8950 SW Nimbus Ave
Beaverton, OR 97008
Phone (503) 253-1105

10121 SE Sunnyside Rd
Ste 170
Clackamas, OR 97015
Phone (877) 540-1614

233 NE 102nd Ave
Portland, OR 97220
Phone (503) 253-1105

Organizations & group practices 8

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1992782692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2925",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072925",
            "telephone_number": "509-895-0402",
            "fax_number": "509-248-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 HOLTON AVE",
            "address_2": "STE 102",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023254",
            "telephone_number": "509-895-0402",
            "fax_number": "509-248-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD23956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BS/BC",
            "identifier": "840126018",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268491",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8323032",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MC",
            "identifier": "P00203830",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.