Individual provider Active NPI

James Liadis, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Everett, WA
National Provider Identifier
1770825127
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD61443248 Issued in WA
Practice address
1303 Pacific Ave
Everett, WA 98201-4234
Phone
(425) 339-5476
Fax
(425) 259-6069
NPI assigned
Mar 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301103007 MI
Physical Medicine & Rehabilitation Physician 208100000X MD080910 GA
Physical Medicine & Rehabilitation Physician 208100000X MTL002296 DC
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X MD61443248 WA Primary

Addresses

Primary practice location

1303 Pacific Ave
Everett, WA 98201-4234

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 304-8431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181217000342 GA Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 8921230913 Reassigns benefits to 1 organization
I20230823001817 WA Practitioner - Physical Medicine and Rehabilitation 8921230913 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

1303 Pacific Ave
Everett, WA 98201-4234
Phone (425) 339-5476

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Internal Medicine CurrentSince Aug 14, 2023 Accepting new patients
Shepherd Center Inc CurrentSince Jul 16, 2018 Accepting new patients
Optum Care Washington PLLC CurrentSince Dec 9, 2023 Accepting new patients
Optum Care Washington PLLC Internal Medicine CurrentSince Dec 9, 2023 Accepting new patients
Optum Care Washington PLLC Internal Medicine Current Accepting new patients
The Polyclinic PLLC Internal Medicine CurrentSince Aug 14, 2023 Accepting new patients

Locations

2020 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 350-7333

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1303 Pacific Ave
Everett, WA 98201
Phone (425) 339-5419

1145 Broadway
Seattle, WA 98122

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: jliadis79263@direct.tecmc.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1770825127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-304-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 PACIFIC AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014234",
            "telephone_number": "425-339-5476",
            "fax_number": "425-259-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIADIS",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301103007",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "MD080910",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "DC",
            "license": "MTL002296",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD61443248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.