Individual provider Active NPI

Jeffrey D Bartlett, M.D.

  • Pediatrics Physician
  • Yakima, WA
National Provider Identifier
1366547416
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00020978 Issued in WA
Practice address
402 S 12TH Ave
Yakima, WA 98902-3115
Phone
(509) 575-0114
Fax
(509) 575-0808
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00020978 WA Primary

Addresses

Primary practice location

402 S 12TH Ave
Yakima, WA 98902-3115

Mailing address

501 S 5TH Ave
Yakima, WA 98902-3550
Phone (509) 853-1082

Other identifiers 3

IdentifierTypeStateIssuer
1003672MedicaidWA
8941844OtherWACRIME VICTIM
080121OtherWALABOR & INDUSTRIES

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041007000288 WA Practitioner - Pediatric Medicine 4284693060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Washington School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health of Central WashingtonGroup PAC ID 4183536931, 77 clinicians

Practice addresses (Care Compare)

1806 W Lincoln Ave
Yakima, WA 98902-2473
Phone (509) 452-4520

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00020978WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health of Central Washington CurrentSince Aug 4, 2010 Accepting new patients
Community Health of Central Washington CurrentSince Aug 4, 2010 Accepting new patients
Community Health of Central Washington Pediatrics Past Accepting new patients

Locations

314 S 11th Ave
Ste A
Yakima, WA 98902
Phone (509) 575-0114

402 S 12th Ave
Yakima, WA 98902
Phone (509) 248-3263

501 S 5th Ave
Yakima, WA 98902
Phone (509) 494-6700

1806 W Lincoln Ave
Yakima, WA 98902
Phone (509) 452-4520

Interoperability endpoints

  • Direct secure messaging: jbartlett605955@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1366547416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 5TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023550",
            "telephone_number": "509-853-1082",
            "fax_number": "509-853-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S 12TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023115",
            "telephone_number": "509-575-0114",
            "fax_number": "509-575-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLETT",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00020978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003672",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIM",
            "identifier": "8941844",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "080121",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.