Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Benjamin Ross Park, DO

Individual provider Diagnostic Radiology Physician · NPI 1770922676

Benjamin Ross Park, DO practises Diagnostic Radiology in Bothell, Washington. Graduated from Michigan State University College of Osteopathic Medicine in 2013, 13 years ago. Practices with Centra Medical Group LLC, a 717-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado, Texas and Virginia.

Years since qualifying
13
Trained at
Michigan State University College of Osteopathic Medicine
Licensed in
CO, TX, VA
In the registry since
2013
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

22100 Bothell Everett Hwy
Bothell, WA 98021-8431
Phone: (208) 416-2932
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 602 Indiana Ave, Lubbock, TX 79415-3364 — (806) 775-8600

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence DR.0061359 (CO)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 0102205720 (VA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence S1673 (TX)

Record details

NPI number1770922676
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 24, 2013
Last updated in NPPESOctober 6, 2026
Certification dateOctober 6, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2013 (13 years in practice)
Group practice Centra Medical Group Llc — 717 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations26 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients1,382
Services billed 2,097 a service is one billed item, such as a visit, a test or a procedure
Average patient age76

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Colleagues at Centra Medical Group LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 717 clinicians in the practice; 12 are shown here.

Other providers in Bothell