NPIMap

Individual provider Active NPI

Jesse Adam Golodner, PA-C

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1669990123
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60796419 Issued in WA
Practice address
2450 33Rd Ave W Ste 100
Seattle, WA 98199-3252
Phone
(206) 320-3364
Fax
(206) 320-5869
NPI assigned
Sep 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60796419 WA Primary

Addresses

Primary practice location

2450 33Rd Ave W Ste 100
Seattle, WA 98199-3252

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

1545 NW Market St Apt 411
Seattle, WA 98107-5257
Phone (215) 791-2425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171027001713 WA Practitioner - Physician Assistant 6002182573 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

2450 33Rd Ave W
Suite 100
Seattle, WA 98199-3252
Phone (206) 320-3364

3400 California Ave SW
Seattle, WA 98116-3307
Phone (206) 403-1601

34503 9TH Ave S
Federal Way, WA 98003-8726

3900 Factoria Blvd SE
Suite a
Bellevue, WA 98006-1234
Phone (206) 320-2001

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • Highline Medical Center Hospital, Burien, WA, CCN 500011
  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60796419WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Nov 11, 2024 Accepting new patients
Highline Medical Group Inc Past Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients

Locations

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

4550 Fauntleroy Way SW
Stop 20601
Seattle, WA 98126

4550 Fauntleroy Way SW
Ste 100
Seattle, WA 98126
Phone (206) 403-1601

3400 California Ave SW
Seattle, WA 98116
Phone (206) 320-3399

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: jgolodner1041749@wm.providencedirect.org

Organizations & group practices 6

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 5

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": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669990123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 33RD AVE W STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981993252",
            "telephone_number": "206-320-3364",
            "fax_number": "206-320-5869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1545 NW Market St Apt 411",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981075257",
            "country_code": "US",
            "telephone_number": "215-791-2425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLODNER",
        "first_name": "JESSE",
        "middle_name": "ADAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60796419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.