Individual provider Active NPI

Jordan M Prutkin, M.D., M.H.S.

  • Clinical Cardiac Electrophysiology Physician
  • Seattle, WA
National Provider Identifier
1760597488
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
MD00044698 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-6340
Phone
(206) 543-0065
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD00044698 WA
Clinical Cardiac Electrophysiology Physician 207RC0001X MD00044698 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-6340

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 543-6420

Other identifiers 2

IdentifierTypeStateIssuer
1760597488MedicaidWA
0250653OtherWAL&I

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
I20090813000696 WA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0042364804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Yale University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

12040 NE 128TH St
Kirkland, WA 98034-3013
Phone (425) 899-1000

1355 N 205TH St
Shoreline, WA 98133-3215
Phone (206) 542-5656

1455 NW Leary Way
Suite 250
Seattle, WA 98107-5138
Phone (206) 789-7777

1550 N 115TH St
Seattle, WA 98133-8401
Phone (206) 364-0500

1570 N 115TH St
Seattle, WA 98133-8401
Phone (206) 306-2800

1701 Columbia Rd
Seattle, WA 98195-0001
Phone (206) 598-3100

17638 140TH Ave NE
Woodinville, WA 98072-6800
Phone (425) 485-4100

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

19917 7TH Ave
Suite 100
Poulsbo, WA 98370-6555
Phone (360) 697-8000

23213 Pacific Hwy S
Kent, WA 98032-2721
Phone (425) 485-4100

24360 Van Ry Blvd
Suite 111
Mountlake Terrace, WA 98043-5457
Phone (206) 598-9091

2505 2ND Ave
Suite 200
Seattle, WA 98121-1495
Phone (206) 443-0400

314 NE Thornton Place
Uwnc Northgate Clinic
Seattle, WA 98125-9000
Phone (206) 528-8000

32018 23Rd Ave S
Federal Way, WA 98003-6022
Phone (253) 839-3030

325 9TH Ave
Seattle, WA 98104-2420
Phone (206) 731-3000

4245 Roosevelt Way NE
Seattle, WA 98105-6008
Phone (206) 598-7954

4915 25TH Ave NE 300
Uwnc Ravenna Clinic
Seattle, WA 98105-5668
Phone (206) 525-7777

620 Kirkland Way
Suite 206
Kirkland, WA 98033-6021
Phone (425) 845-5500

728 Edmonds Way
Rosewood Courte Memory Care
Edmonds, WA 98020-5126
Phone (425) 673-2875

825 Eastlake Ave E
Seattle, WA 98109-4405
Phone (206) 288-1000

Hospital & facility affiliations

  • University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008
  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
  • Fred Hutchinson Cancer Center Hospital, Seattle, WA, CCN 500138
  • Valley Medical Center Hospital, Renton, WA, CCN 500088
  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00044698WAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians CurrentSince Aug 1, 2009 Accepting new patients

Locations

3100 Northup Way
Bellevue, WA 98004
Phone (425) 646-7777

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

1959 NE Pacific St
Fl 3
Seattle, WA 98195
Phone (206) 543-8981

Interoperability endpoints

  • Direct secure messaging: jprutkin99521@direct.ehre.uwmedicine.org

Organizations & group practices 2

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 7

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1760597488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-543-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956340",
            "telephone_number": "206-543-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUTKIN",
        "first_name": "JORDAN",
        "middle_name": "M",
        "credential": "M.D., M.H.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00044698",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WA",
            "license": "MD00044698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760597488",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0250653",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.