Active NPI
Alma Jimenez, PA-C
- Physician Assistant
- Seattle, WA
National Provider Identifier
1336541580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA12923
- Practice address
- 4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367 - Phone
- (206) 616-4001
- NPI assigned
- Sep 18, 2014
- Last updated
- Aug 20, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA12923 | TX | Primary |
| Physician Assistant | 363A00000X | 60612801 | WA |
Addresses
Primary practice location
4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367
Mailing address
4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367
Phone (206) 616-4001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336541580 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA12923 | TX | MD | Physician Assistant |
| 60612801 | WA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goodside Health Medical, PLLC | Physician Assistant | Past | Accepting new patients |
| Peter E. Logerfo, MD, PLLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- NPI 1417435827
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dba Texas MedClinic
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- San Antonio, TX
- NPI 1053784660
-
- Family Medicine Physician
- Puyallup, WA
- NPI 1922190065
-
- Pediatrics Physician
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- NPI 1033972716
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597881600000",
"number": "1336541580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4311 11TH AVE NE STE 200",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981056367",
"telephone_number": "206-616-4001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4311 11TH AVE NE STE 200",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981056367",
"telephone_number": "206-616-4001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "ALMA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-18",
"last_updated": "2020-08-20",
"certification_date": "2020-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA12923",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "60612801",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1336541580",
"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 Aug 20, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.