| Dr Jack Mark Fields, MD | |
|
3417 Ensign Rd Ne, Olympia, WA 98506-5075 | |
| (360) 493-4600 | |
| (360) 493-4603 |
| Full Name | Dr Jack Mark Fields |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 25 Years |
| Location | 3417 Ensign Rd Ne, Olympia, 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 |
|---|---|---|---|
| 1326016379 | NPI | - | NPPES |
| 0384204 | Other | WA | LNI-RADIA |
| 8450157 | Medicaid | WA | |
| 0207711 | Other | WA | LNI-SOUTH SOUND RADIOLOGY |
| 1043717 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | MD00045508 (Washington) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Asante Rogue Regional Medical Center | Medford, OR | Hospital |
| Northwest Specialty Hospital | Post falls, ID | Hospital |
| Swedish Medical Center / Cherry Hill | Seattle, WA | Hospital |
| Swedish Medical Center | Seattle, WA | Hospital |
| Swedish Issaquah | Issaquah, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Swedish Health Services | 0244138196 | 934 |
| South Sound Radiologists Inc P S | 1254229305 | 61 |
| Medford Radiological Group Pc | 2062303324 | 86 |
| Tower Imaging Medical Associates Inc | 2163608688 | 81 |
| Radia Oregon Radiology Medical Group Llc | 2961852637 | 95 |
| Swedish Health Services | 3173433067 | 132 |
| Evergreen Radia Llc | 4587568076 | 101 |
| Central Washington Health Services Association | 4880504596 | 657 |
| Swedish Radia Imaging Center At Edmonds Llc | 5496778292 | 101 |
| Public Hospital District No 4 King County Washington | 6002700861 | 74 |
| Radia Imaging Center Holdings Llc | 6305182965 | 39 |
| Radiology Associates Pa | 7517953912 | 99 |
| Proliance Surgeons Inc P S | 8527972900 | 355 |
| Radia California Radiology Medical Group Inc | 8921465998 | 115 |
| Swedish Health Services | 9537072814 | 323 |
| Radia Inc P S | 9931012812 | 263 |
| County Of Santa Clara | 1254244973 | 824 |
| Entity Name | Central Washington Health Services Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801937453 PECOS PAC ID: 4880504596 Enrollment ID: O20031106000287 |
| Entity Name | Radia Inc P S |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932196607 PECOS PAC ID: 9931012812 Enrollment ID: O20031106000749 |
| Entity Name | Swedish Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831139724 PECOS PAC ID: 9537072814 Enrollment ID: O20031112000189 |
| Entity Name | Proliance Surgeons Inc P S |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023170313 PECOS PAC ID: 8527972900 Enrollment ID: O20031119000128 |
| Entity Name | Evergreen Radia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922095694 PECOS PAC ID: 4587568076 Enrollment ID: O20031125000896 |
| Entity Name | Optum Care Washington Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831186766 PECOS PAC ID: 6406752153 Enrollment ID: O20031211000922 |
| Entity Name | Swedish Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689612954 PECOS PAC ID: 0244138196 Enrollment ID: O20031230000187 |
| Entity Name | Okanogan County Public Hospital District No. 3 |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255387403 PECOS PAC ID: 6800707951 Enrollment ID: O20040128000027 |
| Entity Name | Public Hospital District No 4 King County Washington |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902846546 PECOS PAC ID: 6002700861 Enrollment ID: O20040211001236 |
| Entity Name | South Sound Radiologists Inc P S |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902990500 PECOS PAC ID: 1254229305 Enrollment ID: O20040309001119 |
| Entity Name | Okanogan County Public Hospital Dist No 4 |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750443834 PECOS PAC ID: 9335051150 Enrollment ID: O20040323000641 |
| Entity Name | Swedish Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114356904 PECOS PAC ID: 3173433067 Enrollment ID: O20040414000671 |
| Entity Name | Swedish Radia Imaging Center At Edmonds Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164494373 PECOS PAC ID: 5496778292 Enrollment ID: O20060106000841 |
| Entity Name | Wenatchee Valley Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669719688 PECOS PAC ID: 9537309869 Enrollment ID: O20130716000034 |
| Entity Name | Radia Imaging Center Holdings Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639653017 PECOS PAC ID: 6305182965 Enrollment ID: O20190118000572 |
| Entity Name | Radiology Associates Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366438186 PECOS PAC ID: 7517953912 Enrollment ID: O20200713001634 |
| Entity Name | Direct Imaging Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689283285 PECOS PAC ID: 6103244934 Enrollment ID: O20200910002932 |
| Entity Name | Medford Radiological Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407938111 PECOS PAC ID: 2062303324 Enrollment ID: O20211201002559 |
| Entity Name | Tower Imaging Medical Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023315074 PECOS PAC ID: 2163608688 Enrollment ID: O20230103002616 |
| Entity Name | Radia California Radiology Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740982032 PECOS PAC ID: 8921465998 Enrollment ID: O20231108002477 |
| Entity Name | Radia Oregon Radiology Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073385423 PECOS PAC ID: 2961852637 Enrollment ID: O20240416001942 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jack Mark Fields, MD 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 Ph: (425) 563-1500 | Dr Jack Mark Fields, MD 3417 Ensign Rd Ne, Olympia, WA 98506-5075 Ph: (360) 493-4600 |
Dr. Kevin Joseph Reed, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3417 Ensign Rd Ne, Olympia, WA 98506 Phone: 360-493-4609 Fax: 360-493-4603 | |
Dr. Lawrence Northwood Bennett, MD Radiology Medicare: Medicare Enrolled Practice Location: 3417 Ensign Rd Ne, Olympia, WA 98506 Phone: 360-493-4600 Fax: 360-493-4603 | |
Dr. Samuel J. Boynton, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3417 Ensign Rd Ne, Olympia, WA 98506 Phone: 360-493-4600 Fax: 360-493-4603 | |
Dr. Tariq Hesham Balawi, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3417 Ensign Rd Ne, Olympia, WA 98506 Phone: 360-493-4600 Fax: 360-493-4603 | |
Dr. Jabi Elijah Shriki, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3417 Ensign Road Ne, Olympia, WA 98506 Phone: 360-493-4609 Fax: 360-493-4603 | |
Dr. Christopher Brinson Hartness, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 413 Lilly Rd Ne, Olympia, WA 98506 Phone: 604-937-4603 Fax: 360-493-7253 |