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Active NPI 1285255448 Individual Practitioner Male Practitioner

Dr. Benjamin Wibonele , MD

Otolaryngology • Puyallup, WA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Benjamin Wibonele, MD is a certified Otolaryngology practicing in Puyallup, WA. With approximately 6 years of clinical experience since graduating from Morehouse School Of Medicine in 2020, Dr. Wibonele delivers high-quality medical care to the local community at 104 27TH AVE SE.

Dr. Wibonele is affiliated with Proliance Surgeons Inc P S and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

104 27th Ave Se

Puyallup, WA 983741145

Telephone 2537709000
Fax 2537709712
Associated Practice Facility / Clinic
🏢 Proliance Surgeons Inc Ps Facility NPI 1780610220

Medicare Profile & Education

Medical School

Morehouse School Of Medicine

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Otolaryngology in Puyallup, WA

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -17.1 yrs vs City Avg
City Avg: 23.1 Yrs
State Avg: 23.8 Yrs
Regional Practice Density
11 Specialists

Practicing in Puyallup, WA (318 Statewide)

Telehealth Adoption Rate
36.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wibonele (6 Years) 6 Yrs
Puyallup Specialty Average (23.1 Years) 23.1 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-08-04
Otolaryngology Primary Specialty

NUCC Taxonomy Code: 207Y00000X

State License WA MD61666933

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Otolaryngology - Otology & Neurotology

NUCC Taxonomy Code: 207YX0901X

State License WA MD61666933

An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
2338134 (WA)

Hospital & Practice Group Affiliations

Proliance Surgeons Inc P S

104 27th Ave Se, Puyallup, WA 983741145

Phone: 4257756651

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Dr. Todd Jones , MD

Otolaryngology

NPI 1174727010

Doctor of Medicine (M.D.)

NPI 1316580137

Doctor of Audiology, CCCA

Noah Cope

Audiologist

NPI 1376460774
Dr. Vivian Yu , MD

Otolaryngology

NPI 1427192988

Doctor of Medicine (M.D.)

NPI 1619907953

Doctor of Medicine (M.D.)

NPI 1669589974

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location August 04, 2025

Registered at 104 27TH AVE SE, PUYALLUP, WA 983741145 (Tel: 2537709000)

📍
Updated Business Mailing Address August 04, 2025

Registered at PO BOX 1205, PUYALLUP, WA 983710231 (Tel: 2537709000)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 04, 2025

Otolaryngology (License #MD61666933 in WA)

NPI Profile Active April 29, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location April 29, 2020

Registered at 1364 CLIFTON RD NE, ATLANTA, GA 303221059 (Tel: 4047783381)

📍
Updated Business Mailing Address April 29, 2020

Registered at 1225 DOWNYSHIRE DR, LAWRENCEVILLE, GA 300446097 (Tel: 6784694297)

👤
Provider Name / Credentials Updated April 29, 2020

Recorded as BENJAMIN WIBONELE, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 29, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 29, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1285255448
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 29, 2020
Last Update: August 04, 2025
Sole Proprietor: No

Mailing Address

Po Box 1205

Puyallup, WA 983710231

Phone: 2537709000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.