Individual provider Active NPI

Jennifer M Zumsteg, MD

  • Physical Medicine & Rehabilitation Physician
  • Renton, WA
National Provider Identifier
1417068677
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD60036809 Issued in WA
Practice address
400 S 43Rd St
Renton, WA 98055-5714
Phone
(425) 690-3650
Fax
(425) 690-9650
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD60036809 WA Primary

Addresses

Primary practice location

400 S 43Rd St
Renton, WA 98055-5714

Mailing address

400 S 43Rd St
Renton, WA 98055-5714
Phone (425) 690-3650

Other practice location 1

325 9th Ave
Seattle, WA 98104-2499
Phone (206) 744-3166

Other identifiers 1

IdentifierTypeStateIssuer
2002245MedicaidWA

Other names 1

  • Jennifer M Kettler Former name

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
I20090811000179 WA Practitioner - Physical Medicine and Rehabilitation 2264586205 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60036809WAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Physical Medicine & Rehabilitation CurrentSince Oct 1, 2021 Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

Interoperability endpoints

  • Direct secure messaging: jzumsteg50824@direct.valleymed.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1417068677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-690-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-690-3650",
            "fax_number": "425-690-9650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042499",
            "country_code": "US",
            "telephone_number": "206-744-3166",
            "fax_number": "206-744-8580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZUMSTEG",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD60036809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2002245",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KETTLER",
            "middle_name": "M",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.