Active NPI
Frederick A. Jensen, M.D.
- Specialist
- Olympia, WA
National Provider Identifier
1083715296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD00028618
- Practice address
- 402 Black Hills LN SW
Suite D
Olympia, WA 98502-8145 - Phone
- (360) 754-7881
- Fax
- (360) 357-4974
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD00028618 | WA | Primary |
Addresses
Primary practice location
402 Black Hills LN SW
Suite D
Olympia, WA 98502-8145
Mailing address
402 Black Hills LN SW
Suite D
Olympia, WA 98502-8145
Phone (360) 754-7881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120320000815 | WA | Practitioner - Rheumatology | 6901066406 | Practice locations: Olympia, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Oregon Health Sciences University School of Medicine, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
402 Black Hills LN SW
Suite D
Olympia, WA 98502-8146
Phone (360) 754-7881
Hospital & facility affiliations
- Mason General Hospital & Family of Clinics
- Summit Pacific Medical Center
- Tacoma General Allenmore Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00028618 | WA | MD | Specialist |
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Elma, WA
- NPI 1740211028
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1366556227
-
- Critical Access Hospital
- Shelton, WA
- NPI 1760568752
-
- Foot & Ankle Surgery Podiatrist
- Shelton, WA
- NPI 1437486248
Hospital
-
- Surgery Physician
- Shelton, WA
- NPI 1639339666
Hospital
-
- Ophthalmologic Surgery Clinic/Center
- Shelton, WA
- NPI 1922196609
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083715296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 BLACK HILLS LN SW",
"address_2": "SUITE D",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985028145",
"telephone_number": "360-754-7881",
"fax_number": "360-357-4974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 BLACK HILLS LN SW",
"address_2": "SUITE D",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985028145",
"telephone_number": "360-754-7881",
"fax_number": "360-357-4974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "FREDERICK",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MD00028618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.