Active NPI
Jeffrey Fred Olliffe, M.D.
- Family Medicine Physician
- Seattle, WA
National Provider Identifier
1306838271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 23575
- Practice address
- 1817 12TH Avenue
Seattle, WA 98122 - Phone
- (206) 624-6104
- Fax
- (206) 724-0618
- NPI assigned
- Aug 17, 2005
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 23575 | WA | Primary |
Addresses
Primary practice location
1817 12TH Avenue
Seattle, WA 98122
Mailing address
1817 12TH Avenue
Seattle, WA 98122
Phone (206) 624-6104
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080013515 | Other | WA | RAILROAD MEDICARE # |
| 4079498 | Other | WA | AETNA PROVIDER NUMBER |
| OL5050 | Other | WA | REGENCE PROVIDER NUMBER |
| 57243 | Other | WA | L & I PROVIDER # |
| 1019371 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23575 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peter Shalit, M.D. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Seattle, WA
- NPI 1508043571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443571200000",
"number": "1306838271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1817 12TH AVENUE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98122",
"telephone_number": "206-624-6104",
"fax_number": "206-724-0618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1817 12TH AVENUE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98122",
"telephone_number": "206-624-6104",
"fax_number": "206-724-0618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLLIFFE",
"first_name": "JEFFREY",
"middle_name": "FRED",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-17",
"last_updated": "2015-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "23575",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE #",
"identifier": "080013515",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER NUMBER",
"identifier": "4079498",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE PROVIDER NUMBER",
"identifier": "OL5050",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L & I PROVIDER #",
"identifier": "57243",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1019371",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.