Jacob Daniel Harris, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD60655741 Issued in WA

Practice address

400 E 5TH Ave
Spokane, WA 99202-1334

Phone

(509) 838-2531

Fax

(509) 755-6580

NPI assigned

Jul 2, 2007

Last updated

Dec 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in UT, WA, ID3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Diagnostic Radiology

Education

University of North Dakota School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Radia California Radiology Medical Group IncGroup PAC ID 8921465998, 134 clinicians

Swedish Health ServicesGroup PAC ID 3173433067, 156 clinicians

Radia Inc P SGroup PAC ID 9931012812, 275 clinicians

Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

South Sound Radiologists Inc P SGroup PAC ID 1254229305, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066
• Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
• Swedish Medical Center Hospital, Seattle, WA, CCN 500027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 39)

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.

• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766
  Medicare reassignment Care Compare group NPD
• Radia Inc P S

  dba Radia

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1932196607

  ID

  Medicare reassignment Care Compare group NPD
• South Sound Radiologists Inc P S

  dba South Sound Radiology

  • Diagnostic Radiology Physician
  • Olympia, WA
  • NPI 1902990500
  Medicare reassignment Care Compare group NPD
• Swedish Health Services

  dba Swedish Imaging Clinics

  • Body Imaging Physician
  • Everett, WA
  • NPI 1114356904
  Medicare reassignment Care Compare group NPD
• Swedish Health Services

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1689612954
  Medicare reassignment Care Compare group NPD
• Radia California Radiology Medical Group Inc

  dba Radia California

  • Diagnostic Radiology Physician
  • Santa Rosa, CA
  • NPI 1740982032

  WA

  Medicare reassignment Care Compare group NPD
• Evergreen Radia LLC

  dba Evergreen Radia

  • Diagnostic Radiology Physician
  • Kirkland, WA
  • NPI 1922095694
  Medicare reassignment NPD
• Radia Imaging Center Holdings LLC

  dba Seattle Radiology

  • Diagnostic Radiology Physician
  • Seattle, WA
  • NPI 1639653017
  Medicare reassignment NPD
• Swedish Radia Imaging Center at Edmonds LLC

  dba Swedish Radia Edmonds

  • Diagnostic Radiology Physician
  • Edmonds, WA
  • NPI 1164494373
  Medicare reassignment NPD
• Redwood Radiology Group Inc

  • Diagnostic Radiology Physician
  • Santa Rosa, CA
  • NPI 1326461708

  WA

  Medicare reassignment NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services Washington

  dba Providence Centralia Hospital

  • General Acute Care Hospital
  • Centralia, WA
  • NPI 1376624981
  Care Compare affiliation
• Providence Health & Services-Wa

  dba Providence Regional Medical Center Everett

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation
• Swedish Health Services

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1306992151
  Care Compare affiliation
• North Idaho Day Surgery LLC

  • Multi-Specialty Clinic/Center
  • St Maries, ID
  • NPI 1093674301

  Hospital

  Care Compare affiliation
• North Idaho Day Surgery LLC

  dba Northwest Specialty Hospital

  • General Acute Care Hospital
  • Post Falls, ID
  • NPI 1104824739
  Care Compare affiliation
• North Idaho Day Surgery LLC

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Post Falls, ID
  • NPI 1649123589

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1174720288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021334",
            "telephone_number": "509-838-2531",
            "fax_number": "509-755-6580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19020 33rd Ave W Ste 210",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980364748",
            "country_code": "US",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-13352",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60655741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-RADIA KING CTY",
            "identifier": "0359471",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-EVERGREEN RADIA",
            "identifier": "0359482",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-SOUTH SOUND RADIOLOGY",
            "identifier": "0415521",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-RADIA REST OF WA",
            "identifier": "0359485",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2061893",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-SEATTLE RADIOLOGY",
            "identifier": "0402063",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-VANCOUVER RADIOLOGY",
            "identifier": "0430161",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-SWEDISH RADIA EDMONDS",
            "identifier": "0359483",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174720288",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deena Harris, PT
• Donna Harris, S.W.
• Ellyssa Michelle Harris
• Haylee Anne Harris, MSW, LSWAIC
• Hilary Shannon Harris, MS
• Jennifer Harris, MSW, LICSWA
• Jessica Anna Harris, MASSAGE THERAPIST
• Joseph P Harris, RPH.
• Katherine Rossi Harris
• Kathryn Harris, MS

• Diagnostic Radiology Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Diagnostic Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.

Verify at the official NPI Registry.