| Benjamin Ross Park, DO | |
|
22100 Bothell Everett Hwy, Bothell, WA 98021-8431 | |
| (208) 416-2932 | |
| Not Available |
| Full Name | Benjamin Ross Park |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 12 Years |
| Location | 22100 Bothell Everett Hwy, Bothell, Washington |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770922676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 0102205720 (Virginia) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | DR.0061359 (Colorado) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Enloe Medical Center | Chico, CA | Hospital |
| Carilion New River Valley Medical Center | Christiansburg, VA | Hospital |
| Lakes Region General Hospital | Laconia, NH | Hospital |
| Carilion Medical Center | Roanoke, VA | Hospital |
| Columbus Regional Hospital | Columbus, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Eastern Radiological Associates Pc | 0345232732 | 46 |
| Shannon Clinic | 0840103727 | 465 |
| Oroville Hospital | 1254234339 | 86 |
| Acadiana Radiology Group | 1355403114 | 54 |
| White Mountain Radiology | 2365429123 | 38 |
| Abercrombie Radiological Consultants Inc | 3072411834 | 53 |
| Carolinas Physicians Network Inc. | 3375449655 | 2100 |
| X-ray Professional Association | 3375539927 | 56 |
| Carilion Giles Community Hospital | 3678670221 | 166 |
| Columbus Radiology Physicians Llc | 3971863416 | 60 |
| Carilion Tazewell Community Hospital | 4183604259 | 64 |
| Centra Medical Group Llc | 4789606088 | 681 |
| Jason L Hwang Md Inc | 6103171012 | 46 |
| Radiology Medical Group Of Napa | 7113906397 | 32 |
| Winchester Radiologists Pc | 7113915281 | 63 |
| Tennessee Valley Radiology Llc | 9133105521 | 38 |
| Enloe Medical Center | 9739092388 | 325 |
| Carilion Medical Center | 9830096585 | 914 |
| Shannon Clinic | 0840103727 | 465 |
| Entity Name | Direct Radiology Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144572173 PECOS PAC ID: 9436396165 Enrollment ID: O20130613000219 |
| Entity Name | Optumcare Colorado Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407252828 PECOS PAC ID: 2769706431 Enrollment ID: O20150129000413 |
| Entity Name | Oroville Hospital |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1710372909 PECOS PAC ID: 1254234339 Enrollment ID: O20160407000940 |
| Entity Name | Mountain Medical Physician Specialists Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720035520 PECOS PAC ID: 5294639407 Enrollment ID: O20170818002220 |
| Entity Name | Enloe Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477975613 PECOS PAC ID: 9739092388 Enrollment ID: O20180919003157 |
| Entity Name | Jason L Hwang Md Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811486616 PECOS PAC ID: 6103171012 Enrollment ID: O20181211001080 |
| Entity Name | Simi Radiology And Imaging Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730132275 PECOS PAC ID: 6507845369 Enrollment ID: O20181211002575 |
| Entity Name | Intercity Radiology Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356390736 PECOS PAC ID: 9830003847 Enrollment ID: O20190110000487 |
| Entity Name | Acadiana Radiology Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649422726 PECOS PAC ID: 1355403114 Enrollment ID: O20190503000488 |
| Entity Name | Catawba Radiological Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679684948 PECOS PAC ID: 9335036789 Enrollment ID: O20190711002296 |
| Entity Name | Radiology Consultants Of Lynchburg Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922037043 PECOS PAC ID: 8022077205 Enrollment ID: O20190723000399 |
| Entity Name | Columbus Radiology Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467964718 PECOS PAC ID: 3971863416 Enrollment ID: O20190807000099 |
| Entity Name | Cumberland Imaging Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437279262 PECOS PAC ID: 4284735051 Enrollment ID: O20191219000674 |
| Entity Name | Tennessee Valley Radiology Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356367551 PECOS PAC ID: 9133105521 Enrollment ID: O20200420000744 |
| Entity Name | X-ray Professional Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790758449 PECOS PAC ID: 3375539927 Enrollment ID: O20200831001160 |
| Entity Name | Concord Radiology Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598260515 PECOS PAC ID: 8628332061 Enrollment ID: O20210415002236 |
| Entity Name | White Mountain Radiology |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225018146 PECOS PAC ID: 2365429123 Enrollment ID: O20230110000345 |
| Entity Name | Centra Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649228966 PECOS PAC ID: 4789606088 Enrollment ID: O20231221000339 |
| Entity Name | Cmsc Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639109978 PECOS PAC ID: 5890602494 Enrollment ID: O20240220000938 |
| Entity Name | Eastern Radiological Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639102171 PECOS PAC ID: 0345232732 Enrollment ID: O20240304000300 |
| Entity Name | Carolinas Physicians Network Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386426864 PECOS PAC ID: 3375449655 Enrollment ID: O20240502003119 |
| Entity Name | Carilion Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730123472 PECOS PAC ID: 9830096585 Enrollment ID: O20240814003624 |
| Entity Name | Scott County Community Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1124536990 PECOS PAC ID: 3375829112 Enrollment ID: O20240823000083 |
| Entity Name | Abercrombie Radiological Consultants Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942207154 PECOS PAC ID: 3072411834 Enrollment ID: O20240826001926 |
| Entity Name | Carilion Rockbridge Community Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174636021 PECOS PAC ID: 4789658261 Enrollment ID: O20241009000896 |
| Entity Name | Carilion Giles Community Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194718304 PECOS PAC ID: 3678670221 Enrollment ID: O20241009001359 |
| Entity Name | North Platte Nebraska Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134355332 PECOS PAC ID: 6507856697 Enrollment ID: O20241011003060 |
| Entity Name | Carilion Tazewell Community Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427040328 PECOS PAC ID: 4183604259 Enrollment ID: O20241107004074 |
| Entity Name | Winchester Radiologists Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235123977 PECOS PAC ID: 7113915281 Enrollment ID: O20241203003955 |
| Entity Name | Memorial Hospital Of Converse County |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356496491 PECOS PAC ID: 2264340843 Enrollment ID: O20250207001302 |
| Entity Name | Radiology Medical Group Of Napa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285666313 PECOS PAC ID: 7113906397 Enrollment ID: O20250325003502 |
| Entity Name | Shannon Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770587149 PECOS PAC ID: 0840103727 Enrollment ID: O20250506002354 |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Ross Park, DO 669 Carved Ter, Colorado Springs, CO 80919-1130 Ph: () - | Benjamin Ross Park, DO 22100 Bothell Everett Hwy, Bothell, WA 98021-8431 Ph: (208) 416-2932 |
Darryn Hiroshi Matsushima, RDMS Radiology Medicare: Not Enrolled in Medicare Practice Location: 105 167th Pl Sw, Bothell, WA 98012 Phone: 503-803-9866 | |
Michael David Berven, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 22100 Bothell Everett Hwy, Bothell, WA 98021 Phone: 855-687-7237 |