Jacob Andrew Sedrick, DO

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

2015014437 Issued in MO

Practice address

3124 Jessica St
Joplin, MO 64804-1398

Phone

(810) 429-0514

NPI assigned

Jun 10, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Diagnostic Radiology

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tra-Minw P SGroup PAC ID 2163316167, 152 clinicians

Medical Imaging Northwest - Good Samaritan Hospital Imaging AllianceGroup PAC ID 3375603970, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
• Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
• Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ei-trami

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.

• Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1083802946

  UT

  Medicare reassignment Care Compare group NPD
• Tra-Minw P S

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1396814166

  UT

  Medicare reassignment Care Compare group NPD
• Green River Radiology, P.C.

  dba RAYUS Radiology

  • Diagnostic Radiology Physician
  • Pleasant Grove, UT
  • NPI 1508533878
  Medicare reassignment NPD
• Tooele Valley Imaging, LLC

  dba First Choice Imaging

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Tooele, UT
  • NPI 1699004499
  Medicare reassignment NPD
• Tra Medical Imaging Centers LLC

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1447041751

  UT

  Medicare reassignment NPD
• Union Avenue Open MRI LLC

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1568531242

  UT

  Medicare reassignment NPD
• Eastpointe Radiologists, PC

  dba Grosse Pointe Physicians Xray Center, PC

  • Diagnostic Radiology Physician
  • Grosse Pointe Woods, MI
  • NPI 1558409649
  NPD (past)
• Tra-Minw P S

  • Radiology Clinic/Center
  • Federal Way, WA
  • NPI 1184790032
  NPD (past)

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

• Multicare Health System

  dba MultiCare Covington Medical Center

  • General Acute Care Hospital
  • Covington, WA
  • NPI 1326564071
  Care Compare affiliation
• Multicare Health System

  dba Tacoma General Allenmore

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  Care Compare affiliation
• Multicare Health System

  dba MultiCare Good Samaritan Hospital

  • General Acute Care Hospital
  • Puyallup, WA
  • NPI 1841231461
  Care Compare affiliation

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1699935064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 JESSICA ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041398",
            "telephone_number": "810-429-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 JESSICA ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041398",
            "telephone_number": "810-429-0514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 Fawcett Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984021900",
            "country_code": "US",
            "telephone_number": "253-761-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEDRICK",
        "first_name": "JACOB",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "5812",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "0538184",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "34011141",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2015014437",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "OP61464282",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E-13387",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200590630A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699935064",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• SCPG Missouri LLC (Express Rx of Joplin)
• Ward Kirk Seale, PHARMD
• Joan Lucille Searles, LCSW
• Secure of Joplin Mo DDS LLC
• Shelly Diane Sedberry, D.P.M.
• Victoria Seela
• Britney Seger, RBT
• David A Seidl, MD
• Earnst Douglas Seifert, MD
• Henrik Joergen Seifert, DC

• Diagnostic Radiology Physician in Joplin, MO
• Providers in Joplin, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.