NPIMap

Organization Active NPI

Brian D Jaeger MD PS Inc

  • Adult Mental Health Clinic/Center
  • Redmond, WA
National Provider Identifier
1396915385
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
MD00046421 Issued in WA
Legal business name
BRIAN D JAEGER MD PS INC
Practice address
8301 161St Ave NE Ste 300
Redmond, WA 98052-3858
Phone
(425) 885-3330
Fax
(425) 702-2474
NPI assigned
Mar 5, 2008
Last updated
Mar 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Dr. Brian D Jaeger, M.D.NPI 1396832572
Title
President
Phone
(425) 885-3330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X MD00046421 WA Primary

Addresses

Primary practice location

8301 161St Ave NE Ste 300
Redmond, WA 98052-3858

Mailing address

8301 161St Ave NE Ste 300
Redmond, WA 98052-3858
Phone (425) 885-3330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080319000130 WA Part B Supplier - Clinic/Group Practice 8628154408 Receives reassigned benefits from 1 practitioner
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Locations

8301 161st Ave NE
Ste 300
Redmond, WA 98052
Phone (206) 885-3330

2808 E Madison St
Ste 201
Seattle, WA 98112
Phone (206) 323-6909

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1396915385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 161ST AVE NE STE 300",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523858",
            "telephone_number": "425-885-3330",
            "fax_number": "425-702-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 161ST AVE NE STE 300",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523858",
            "telephone_number": "425-885-3330",
            "fax_number": "425-702-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN D JAEGER MD PS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "JAEGER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-885-3330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "WA",
            "license": "MD00046421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.