Individual provider Active NPI

Jordan Maag

  • Certified Registered Nurse Anesthetist
  • Spokane, WA
National Provider Identifier
1548707920
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60741548 Issued in WA
Practice address
101 W 8TH Ave
Spokane, WA 99204-2307
Phone
(509) 474-3131
NPI assigned
Jan 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60714615 WA
Certified Registered Nurse Anesthetist 367500000X AP60741548 WA Primary

Addresses

Primary practice location

101 W 8TH Ave
Spokane, WA 99204-2307

Mailing address

PO Box 94645
Seattle, WA 98124-6945
Phone (509) 474-3131

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmaag795176@wm.providencedirect.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170329002579 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496030603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Service- WashingtonGroup PAC ID 0840279758, 170 clinicians

Practice addresses (Care Compare)

101 W 8TH Ave
Spokane, WA 99204-2307
Phone (509) 474-3131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.73 of 100Reported as group
Quality
83.21
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60714615WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Service- Washington CurrentSince Apr 15, 2017 Accepting new patients

Locations

5633 N Lidgerwood St
Spokane, WA 99208
Phone (509) 482-0111

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1548707920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94645",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246945",
            "telephone_number": "509-474-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-474-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAAG",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-24",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60714615",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60741548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmaag795176@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "101 W 8th Ave",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992042307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.