Active NPI
Jaclyn Mahlstede, ARNP
- Family Nurse Practitioner
- Bellevue, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP60820546
- Practice address
- 1135-116TH Avenue NE
Suite 200
Bellevue, WA 98004 - Phone
- (520) 324-2160
- Fax
- (520) 324-1460
- NPI assigned
- Feb 8, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 60820546 | WA | |
| Family Nurse Practitioner | 363LF0000X | AP60820546 | WA | Primary |
Addresses
Primary practice location
1135-116TH Avenue NE
Suite 200
Bellevue, WA 98004
Mailing address
Ms 315010
PO Box 3947
Seattle, WA 98124-3947
Phone (425) 467-3655
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2145072 | Medicaid | WA | |
| 791187 | Medicaid | AZ |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1231 116TH Ave NE
Bellevue, WA 98004-3804
1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460
22630 SE 4TH St
Suite 300
Sammamish, WA 98074-7131
Phone (425) 635-3070
5708 E Lake Samm Pkwy SE
Issaquah, WA 98029-8942
Phone (425) 688-5488
619 156TH Ave SE
Bellevue, WA 98007-5328
Phone (425) 637-3270
Hospital & facility affiliations
- Overlake Hospital Medical Center & Clinics
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.73 of 100
- Quality
- 73.46
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60820546 | WA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Overlake Medical Clinics, LLC | Current | Accepting new patients | |
| Overlake Medical Clinics LLC | Current | Accepting new patients | |
| Issaquah Obstetrics and Gynecology PLLC | Past | Accepting new patients |
Locations
1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460
1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141
5708 E Lake Sammamish Pkwy SE
Ste 101
Issaquah, WA 98029
6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777
13159 Newcastle Commons Dr
Newcastle, WA 98059
Phone (425) 635-3010
Interoperability endpoints
- jaclyn.mahlstede.1@19198.direct.athenahealth.com
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.
-
- Specialist
- Bellevue, WA
- NPI 1801828421
-
- Specialist
- Bellevue, WA
- NPI 1871745703
-
- Obstetrics & Gynecology Physician
- Issaquah, WA
- NPI 1073581807
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bellevue, WA
- NPI 1598971855
-
- General Acute Care Hospital
- Bellevue, WA
- NPI 1861432726
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589414400000",
"number": "1659610764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MS 315010",
"address_2": "PO BOX 3947",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981243947",
"telephone_number": "425-467-3655",
"fax_number": "425-835-6388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135-116TH AVENUE NE",
"address_2": "SUITE 200",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "98004",
"telephone_number": "520-324-2160",
"fax_number": "520-324-1460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHLSTEDE",
"first_name": "JACLYN",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-08",
"last_updated": "2020-05-14",
"certification_date": "2020-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "60820546",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP60820546",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2145072",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "791187",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.