Active NPI
Jonathan Lee Renslo, MD
- Surgery Physician
- Seattle, WA
National Provider Identifier
1376346288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MDRE.ML.61683253
- Practice address
- 747 Broadway BLDG 10TH
Seattle, WA 98122-4379 - Phone
- (206) 215-4253
- NPI assigned
- Mar 28, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MDRE.ML.61683253 | WA | Primary |
Addresses
Primary practice location
747 Broadway BLDG 10TH
Seattle, WA 98122-4379
Mailing address
1000 Minor Ave Apt 1106
Seattle, WA 98104-1392
Phone (310) 961-6462
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250623002644 | WA | Order and Referring Only - Diagnostic Radiology | 9032621305 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MDRE.ML.61683253 | WA | MD | Surgery Physician |
Interoperability endpoints
- jrenslo3862993@wm.providencedirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750377600000",
"number": "1376346288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 MINOR AVE APT 1106",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041392",
"telephone_number": "310-961-6462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "747 BROADWAY BLDG 10TH",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981224379",
"telephone_number": "206-215-4253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENSLO",
"first_name": "JONATHAN",
"middle_name": "LEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-28",
"last_updated": "2025-06-20",
"certification_date": "2025-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "MDRE.ML.61683253",
"primary": true
}
],
"identifiers": [],
"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 Jun 20, 2025; 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.