Lidia Wiersum

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP60321256 Issued in WA

Practice address

2445 270TH Ave SE
Issaquah, WA 98029-7901

Phone

(262) 748-5588

NPI assigned

Nov 21, 2012

Last updated

Oct 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026
• Swedish Medical Center Hospital, Seattle, WA, CCN 500027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwiersum1043621@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1831139724
  Medicare reassignment Care Compare group NPD
• Swedish Health Services

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1689612954
  Medicare reassignment NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Miranova Health PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Seattle, WA
  • NPI 1932730447
  NPD
• Swedish Health Services

  dba One Medical

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1073553947
  NPD
• Swedish Health Services

  dba Swedish Physician Division

  • General Practice Physician
  • Renton, WA
  • NPI 1497129696
  NPD
• Swedish Health Services

  • Physical Therapist
  • Seattle, WA
  • NPI 1619680840
  NPD

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

• Swedish Edmonds

  • General Acute Care Hospital
  • Edmonds, WA
  • NPI 1033107214
  Care Compare affiliation
• Swedish Edmonds

  • Clinical Medical Laboratory
  • Edmonds, WA
  • NPI 1699894022

  Hospital

  Care Compare affiliation
• Swedish Health Services

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1306992151
  Care Compare affiliation

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1558605071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 270TH AVE SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980297901",
            "telephone_number": "262-748-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 270TH AVE SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980297901",
            "telephone_number": "262-748-5588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 5th Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981043186",
            "country_code": "US",
            "telephone_number": "206-317-1956",
            "fax_number": "206-320-7195",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19401 40th Ave W Ste 230",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980365675",
            "country_code": "US",
            "telephone_number": "425-744-7153",
            "fax_number": "425-744-7123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "747 Broadway # Wwa11B",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981224379",
            "country_code": "US",
            "telephone_number": "206-320-3417",
            "fax_number": "206-320-7195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIERSUM",
        "first_name": "LIDIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP60321256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwiersum1043621@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "747 Broadway # Wwa11B",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981224379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwiersum1043621@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "800 5th Ave Ste 600",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981043186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwiersum1043621@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "19401 40th Ave W Ste 230",
            "city": "Lynnwood",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980365675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kellie Whitcomb, R.D.H.
• Jane White
• Talia White, CBT
• Whole Centered Health
• Whole Health Chiropractic Center
• Elijah Wild, LMHCA
• Jennifer L. Wilde, DPT
• Pamela Wilensky, LMFT
• Lani Wilhite, RPH
• Amanda Marie Willert, LMT

• Gerontology Nurse Practitioner in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.