Jaime Carrillo, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1401 Madison St Ste 100
Seattle, WA 98104-1316

Phone

(206) 386-6054

Fax

(206) 215-6027

NPI assigned

Apr 15, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jaime Orlando Carrillo-Martinez Other name

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

Specialty

Family Practice

Education

Texas Tech University Health Science Center School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seattle Roots Community HealthGroup PAC ID 8628966173, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Seattle Roots Community Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1972623189
  Medicare reassignment Care Compare group NPD
• Seattle Roots Community Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1891343075
  NPD
• Seattle Roots Community Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1164642278
  NPD (past)
• Seattle Roots Community Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1497189773
  NPD (past)

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1528649282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 MONTGOMERY BLVD NE APT 306",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091086",
            "telephone_number": "832-410-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MADISON ST STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041316",
            "telephone_number": "206-386-6054",
            "fax_number": "206-215-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "JAIME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIME",
            "last_name": "CARRILLO-MARTINEZ",
            "middle_name": "ORLANDO",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lydia G Carrick, LMHC, LPC, NCC
• Carrie Cole, PLLC
• Yvette Carrillo-Bernal
• April I Carrillo, RN, BSN
• Carole Carrillo, MSW, LICSW
• William Joseph Carriveau, PT
• Aidan Carroll
• Ariel J Carroll
• Brant F Carroll, M.D.
• Brenna S Carroll, L.D.

• Student in an Organized Health Care Education/Training Program in Seattle, WA
• Providers in Seattle, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.