Individual provider Active NPI

Annelise Marjolein Jacobsen Gaaserud, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1427256809
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ML20008175 Issued in WA
Practice address
125 16TH Ave E
Capitol Hill Campus South Building
Seattle, WA 98112-5211
Phone
(206) 326-3530
Fax
(206) 326-3558
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ML20008175 WA Primary

Addresses

Primary practice location

125 16TH Ave E
Capitol Hill Campus South Building
Seattle, WA 98112-5211

Mailing address

125 16TH Ave E
Seattle, WA 98112-5211
Phone (206) 326-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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
I20090324000576 WA Practitioner - Family Practice 0749347417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

125 16TH Ave E
Seattle, WA 98112-5211
Phone (206) 326-2662

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML20008175WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Dec 31, 2009 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince Dec 31, 2009 Accepting new patients

Locations

125 16th Ave E
Seattle, WA 98112
Phone (206) 326-3530

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: agaaserud891@ghc.direct-ci.net

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": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1427256809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 16TH AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981125211",
            "telephone_number": "206-326-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 16TH AVE E",
            "address_2": "CAPITOL HILL CAMPUS SOUTH BUILDING",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981125211",
            "telephone_number": "206-326-3530",
            "fax_number": "206-326-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAASERUD",
        "first_name": "ANNELISE",
        "middle_name": "MARJOLEIN JACOBSEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ML20008175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "125 16th Ave E",
            "address_2": "Capitol Hill Campus South Building",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.