NPIMap

Individual provider Active NPI

Matthew V Jenkins, M.D.

  • Orthopaedic Surgery Physician
  • Lakewood, WA
National Provider Identifier
1821263807
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD60230908 Issued in WA
Practice address
7308 Bridgeport Way W
Suite 201
Lakewood, WA 98499-8000
Phone
(253) 582-7257
Fax
(253) 582-1617
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD60230908 WA Primary

Addresses

Primary practice location

7308 Bridgeport Way W
Suite 201
Lakewood, WA 98499-8000

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other identifiers 2

IdentifierTypeStateIssuer
2012736MedicaidWA
346700OtherWAWA STATE LNI

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
I20110809000810 WA Practitioner - Orthopedic Surgery 7911176854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Washington School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

7308 Bridgeport Way W
Suite 201
Lakewood, WA 98499-8000
Phone (253) 582-7257

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)19

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Orthopaedic Surgery Current Accepting new patients
Proliance Surgeons, Inc., P.S. Orthopaedic Surgery CurrentSince Jan 1, 2016 Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery CurrentSince Jan 1, 2016 Accepting new patients
Proliance Surgeons, Inc., P.S. Past Accepting new patients

Locations

2727 Hollycroft St
Ste 410
Gig Harbor, WA 98335
Phone (253) 358-4002

7308 Bridgeport Way W
Ste 201
Lakewood, WA 98499
Phone (253) 582-7257

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: mjenkins8662@fhsce.catholichealth.net
  • Direct secure messaging: matthew.jenkins.p73@direct.proliance.nextgenshare.com

Organizations & group practices 4

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 4

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": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1821263807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7308 BRIDGEPORT WAY W",
            "address_2": "SUITE 201",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998000",
            "telephone_number": "253-582-7257",
            "fax_number": "253-582-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MATTHEW",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD60230908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2012736",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE LNI",
            "identifier": "346700",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.