Individual provider Active NPI

Annisa L. Jamil, M.D.

  • Glaucoma Specialist (Ophthalmology) Physician
  • Seattle, WA
National Provider Identifier
1629006135
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X
License
MD00044821 Issued in WA
Practice address
1101 Madison St
Ste 600
Seattle, WA 98104-3501
Phone
(206) 215-2020
Fax
(206) 215-2022
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 44821 WA
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X MD00044821 WA Primary

Addresses

Primary practice location

1101 Madison St
Ste 600
Seattle, WA 98104-3501

Mailing address

1101 Madison St
Ste 600
Seattle, WA 98104-3501
Phone (206) 215-2020

Other practice location 1

1229 Madison St Ste 620
Seattle, WA 98104-3304
Phone (206) 215-3850

Other practice location 2

1750 112th Ave NE Ste D050
Bellevue, WA 98004-3779
Phone (206) 215-3850

Other identifiers 1

IdentifierTypeStateIssuer
1014828MedicaidWA

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
I20050714001014 WA Practitioner - Ophthalmology 6406822618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Associates Northwest PLLCGroup PAC ID 2961397385, 10 clinicians
Evergreen Eye Center PLLCGroup PAC ID 3173410057, 33 clinicians

Practice addresses (Care Compare)

1101 Madison St
Suite 600
Seattle, WA 98104-3501
Phone (206) 215-2020

11325 NE 120TH St
Kirkland, WA 98034-6907
Phone (425) 821-6655

1455 NW Leary Way
Suite 300
Seattle, WA 98107-5138
Phone (206) 784-3350

34719 6TH Ave S
Federal Way, WA 98003-8714
Phone (206) 212-2100

Merit-based Incentive Payment System (MIPS)

Final score
84.62 of 100Reported as group
Quality
85.07
Improvement activities
40
Cost
76.1

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44821WAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Eye Center, PLLC CurrentSince Sep 1, 2021 Accepting new patients
Evergreen Eye Center, PLLC Ophthalmology Current Accepting new patients
Eye Associates Northwest, PLLC Ophthalmology CurrentSince Sep 1, 2021 Accepting new patients
Evergreen Eye Center, PLLC Ophthalmology CurrentSince Apr 8, 2024 Accepting new patients
Evergreen Eye Center, PLLC Ophthalmology Past Accepting new patients
Evergreen Eye Center, PLLC Ophthalmology Past Accepting new patients
Evergreen Eye Center, PLLC Past Accepting new patients

Locations

1750 112th Ave NE
Ste D050
Bellevue, WA 98004
Phone (425) 296-3837

34719 6th Ave S
Federal Way, WA 98003
Phone (206) 212-2100

11325 NE 120th St
Kirkland, WA 98034
Phone (425) 821-6655

11919 NE 128th St
Ste A
Kirkland, WA 98034
Phone (425) 820-6307

1229 Madison St
Ste 680
Seattle, WA 98104
Phone (206) 812-9470

1455 NW Leary Way
Ste 300
Seattle, WA 98107
Phone (206) 784-3350

1101 Madison St
Ste 200
Seattle, WA 98104
Phone (206) 320-7750

1101 Madison St
Ste 600
Seattle, WA 98104
Phone (206) 215-2004

1229 Madison St
Ste 620
Seattle, WA 98104

Interoperability endpoints

  • Direct secure messaging: annisa.jamil.p16@direct.proliance.nextgenshare.com

Organizations & group practices 7

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1629006135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST",
            "address_2": "STE 600",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043501",
            "telephone_number": "206-215-2020",
            "fax_number": "206-215-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST",
            "address_2": "STE 600",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043501",
            "telephone_number": "206-215-2020",
            "fax_number": "206-215-2022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1229 Madison St Ste 620",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981043304",
            "country_code": "US",
            "telephone_number": "206-215-3850",
            "fax_number": "206-215-3870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1750 112th Ave NE Ste D050",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980043779",
            "country_code": "US",
            "telephone_number": "206-215-3850",
            "fax_number": "206-215-3870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMIL",
        "first_name": "ANNISA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "44821",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "WA",
            "license": "MD00044821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014828",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.