Active NPI
Jeffrey Lynn Pett, MD
- Anatomic Pathology & Clinical Pathology Physician
- Spokane Valley, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- MD61113399
- Practice address
- 13103 E Mansfield Avenue
Spokane Valley, WA 99216-1642 - Phone
- (509) 892-2700
- Fax
- (509) 892-2740
- NPI assigned
- Mar 3, 2006
- Last updated
- Feb 17, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | MD61113399 | WA | Primary |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 22578 | AZ |
Addresses
Primary practice location
13103 E Mansfield Avenue
Spokane Valley, WA 99216-1642
Mailing address
PO Box 3405
Spokane, WA 99220-3405
Phone (509) 892-2700
Other practice location 1
424 S 56th St Ste 120
Phoenix, AZ 85034-2177
Phone (602) 685-5211
Other practice location 2
1900 N Higley Rd
Gilbert, AZ 85234-1604
Phone (602) 685-5211
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 199308 | Medicaid | AZ | |
| 2170571 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, ID, WA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Baylor College of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13103 E Mansfield Ave
Spokane Valley, WA 99216-1642
Phone (509) 892-2700
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-4000
Hospital & facility affiliations
- Yakima Valley Memorial
- Grande Ronde Hospital
- Kadlec Regional Medical Center
- Prosser Memorial Hospital
- Good Shepherd Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 73.29 of 100
- Quality
- 68.58
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22578 | AZ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Incyte Pathology, LLC | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| Clin-Path Pathology | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| Sonoran Radiology LTD | Past | Accepting new patients |
Locations
1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000
1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000
1800 E Van Buren St
Phoenix, AZ 85006
Phone (602) 251-8100
2000 W Bethany Home Rd
Phoenix, AZ 85015
Phone (480) 209-4000
424 S 56th St
Ste 110
Phoenix, AZ 85034
Phone (480) 478-8057
1255 W Washington St
Tempe, AZ 85288
Phone 602685521145166
1500 S Mill Ave
Tempe, AZ 85281
Phone (480) 784-5500
2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085
500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918
3001 St Anthony Way
Ste 107
Pendleton, OR 97801
Phone (541) 278-4755
221 Wellsian Way
Richland, WA 99352
Phone (503) 341-9352
13103 E Mansfield Ave
Spokane Valley, WA 99216
2811 S 102nd St
Ste 170
Tukwila, WA 98168
Phone (425) 646-0922
55 W Tietan St
Walla Walla, WA 99362
Phone (509) 525-3720
Interoperability endpoints
- jeffrey_pett_md@yourcarecommunity.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba InCyte Pathology
- Anatomic Pathology & Clinical Pathology Physician
- Spokane Valley, WA
- NPI 1326086745
ID, OR
-
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
- NPI 1922079706
-
- Vascular & Interventional Radiology Physician
- Mesa, AZ
- NPI 1033745708
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Richland, WA
- NPI 1972507580
-
dba Prosser Memorial Health
- Critical Access Hospital
- Prosser, WA
- NPI 1306897681
-
dba MultiCare Yakima Memorial Hospital
- General Acute Care Hospital
- Yakima, WA
- NPI 1053373480
-
dba Good Shepherd Medical Center
- Critical Access Hospital
- Hermiston, OR
- NPI 1295789667
-
dba Grande Ronde Hospital Childrens Clinic
- Pediatrics Physician
- La Grande, OR
- NPI 1861434615
Hospital
-
dba Grande Ronde Hospital Womens Clinic
- Obstetrics & Gynecology Physician
- La Grande, OR
- NPI 1972545895
Hospital
-
dba Grande Ronde Hospital Internal Medicine Clinic
- Primary Care Clinic/Center
- La Grande, OR
- NPI 1174553929
Hospital
-
- Critical Access Hospital
- La Grande, OR
- NPI 1467446195
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676592000000",
"number": "1679540009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3405",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992203405",
"telephone_number": "509-892-2700",
"fax_number": "509-892-2740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13103 E MANSFIELD AVENUE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992161642",
"telephone_number": "509-892-2700",
"fax_number": "509-892-2740"
}
],
"practiceLocations": [
{
"address_1": "424 S 56th St Ste 120",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850342177",
"country_code": "US",
"telephone_number": "602-685-5211",
"fax_number": "602-685-5325",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1900 N Higley Rd",
"address_purpose": "LOCATION",
"city": "Gilbert",
"state": "AZ",
"postal_code": "852341604",
"country_code": "US",
"telephone_number": "602-685-5211",
"fax_number": "602-685-5325",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETT",
"first_name": "JEFFREY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-03",
"last_updated": "2023-02-17",
"certification_date": "2023-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "WA",
"license": "MD61113399",
"primary": true
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "AZ",
"license": "22578",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "199308",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2170571",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.