Active NPI
Jamie R Antoine, MD
- Orthopaedic Surgery Physician
- Kirkland, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MD60007110
- Practice address
- 12911 120TH Ave NE Ste H210
Kirkland, WA 98034 - Phone
- (425) 823-4000
- Fax
- (425) 821-3550
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | MD60007110 | WA | |
| Orthopaedic Surgery Physician | 207X00000X | MD60007110 | WA | Primary |
Addresses
Primary practice location
12911 120TH Ave NE Ste H210
Kirkland, WA 98034
Mailing address
12911 120TH Ave NE Ste G10
Kirkland, WA 98034-3048
Phone (425) 823-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1090846 | Medicaid | WA |
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
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Albany Medical College of Union University, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12911 120TH Ave NE
Suite H120
Kirkland, WA 98034-3062
Phone (425) 823-4226
12911 120TH Ave NE
Suite H210
Kirkland, WA 98034-3065
Phone (425) 823-4000
Hospital & facility affiliations
- Evergreenhealth Home Care Services
- Evergreenhealth Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Knee replacement | 1-10 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60007110 | WA | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proliance Surgeons Inc P S | Orthopaedic Surgery | Current | Accepting new patients |
| Proliance Surgeons Inc P S | Orthopaedic Surgery | Current | Accepting new patients |
| Proliance Surgeons Inc P S | Orthopaedic Surgery | Current | Accepting new patients |
| Proliance Surgeons, Inc., P.S. | Past | Accepting new patients |
Locations
12911 120th Ave NE
Ste G10
Kirkland, WA 98034
Phone (425) 481-6301
12911 120th Ave NE
Ste H120
Kirkland, WA 98034
Phone (425) 823-4226
12911 120th Ave NE
Ste H210
Kirkland, WA 98034
Phone (425) 823-4000
805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Seattle, WA
- NPI 1023170313
-
- Orthopaedic Surgery Physician
- Renton, WA
- NPI 1235091463
-
- Orthopaedic Surgery Physician
- Kirkland, WA
- NPI 1669411617
-
- Otolaryngology Physician
- Burien, WA
- NPI 1114108784
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kirkland, WA
- NPI 1033174933
-
- Home Health Agency
- Kirkland, WA
- NPI 1588662761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647993600000",
"number": "1114022969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12911 120TH AVE NE STE G10",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980343048",
"telephone_number": "425-823-4000",
"fax_number": "425-821-3550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12911 120TH AVE NE STE H210",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "98034",
"telephone_number": "425-823-4000",
"fax_number": "425-821-3550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTOINE",
"first_name": "JAMIE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2022-03-23",
"certification_date": "2022-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "WA",
"license": "MD60007110",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "WA",
"license": "MD60007110",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1090846",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.