Individual provider Active NPI

Jonathan Halper, MD

  • Emergency Medicine Physician
  • Snoqualmie, WA
National Provider Identifier
1114952082
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00024322 Issued in WA
Practice address
9801 Frontier Ave SE
Snoqualmie, WA 98065-5200
Phone
(425) 831-2300
Fax
(425) 831-2361
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD00024322 WA Primary

Addresses

Primary practice location

9801 Frontier Ave SE
Snoqualmie, WA 98065-5200

Mailing address

9801 Frontier Ave SE
Snoqualmie, WA 98065-5200
Phone (425) 831-2300

Other identifiers 3

IdentifierTypeStateIssuer
0025694OtherWALABOR & INDUSTRIES
8306144MedicaidWA
02678UOtherWAREGENCE BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040426000487 WA Practitioner - Emergency Medicine 6507852357 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00024322WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Washington CurrentSince Sep 17, 2002 Accepting new patients
University of Washington CurrentSince Sep 17, 2002 Accepting new patients
Public Hospital District No 4, King County Wa Past Accepting new patients
Ballard Emergency Physicians, P.S. Emergency Medicine Past Accepting new patients
Black Hills Emergency Physicians Emergency Medicine Past Accepting new patients
Puget Sound Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

4333 Brooklyn Ave NE
Seattle, WA 98195
Phone (206) 685-5648

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1114952082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 FRONTIER AVE SE",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980655200",
            "telephone_number": "425-831-2300",
            "fax_number": "425-831-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 FRONTIER AVE SE",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980655200",
            "telephone_number": "425-831-2300",
            "fax_number": "425-831-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALPER",
        "first_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00024322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0025694",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8306144",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "02678U",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snoqualmie, WA

Sources for this page

Verify at the official NPI Registry.