Jeffery R Adams, MD
Individual provider Active NPI Otolaryngology Physician · Everett, WA
NPI 1104891175 · NPPES record last updated Dec 6, 2016
Key facts
- NPI
- 1104891175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- MD00039990 (WA)
- Practice address
- 3927 Rucker Ave
Everett, WA 98201-4833 - Phone
- (425) 339-5441
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 21
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Otolaryngology
- Education
- University of Washington School of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Optum Care Washington PLLC
Practice addresses (Care Compare)
3927 Rucker Ave
Everett, WA 98201-4833
Phone (425) 339-3930
Hospital & facility affiliations
- Providence Regional Medical Center Everett
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100929000953 | WA | Practitioner - Otolaryngology | 4183740954 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Care Washington PLLC | Current |
Accepting new patients | |
| Optum Care Washington PLLC | Current |
Accepting new patients | |
| Optum Care Washington PLLC | Past | Accepting new patients |
Locations
21401 72nd Ave W
Edmonds, WA 98026
Phone (425) 304-1101
3927 Rucker Ave
Bldg Ksc
Everett, WA 98201
1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903
3927 Rucker Ave
Everett, WA 98201
Phone (425) 339-5419
1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299
Interoperability endpoints
- jadams1334@direct.tecmc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | MD00039990 | WA | Yes |
Addresses
Primary practice location
3927 Rucker Ave
Everett, WA 98201-4833
Mailing address
PO Box 5127
Everett, WA 98206-5127
Phone (425) 258-3900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1002536 | Medicaid | WA |
Other providers in Everett, WA
- Peter Y Ackerman
- Sara Ackerman
- Barbara Acoba
- Dian Acosta
- Kathryn E Adair
- Jennifer Adams
- Linda G. Adams
- Megan Nicole Adams
- Michael Stewart Adams
- Paul Anthony Adams
All providers in Everett, WA · Otolaryngology Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.