Active NPI
Janelle M Ibsen, PA
- Physician Assistant
- Everett, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10005326
- Practice address
- 3901 Hoyt Ave
Everett, WA 98201-4918 - Phone
- (425) 339-5446
- Fax
- (425) 303-3091
- NPI assigned
- Dec 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10005326 | WA | Primary |
Addresses
Primary practice location
3901 Hoyt Ave
Everett, WA 98201-4918
Mailing address
1019 112TH St SW
Everett, WA 98204
Phone (425) 551-6200
Other practice location 1
1019 112th St SW
Everett, WA 98204
Phone (425) 551-6200
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Select Outpatient Services Inc
Practice addresses (Care Compare)
1330 Rockefeller Ave
Everett, WA 98201-1684
Phone (425) 259-0966
2600 Compass Rd
Glenview, IL 60026-8001
2901 174TH St NE
Marysville, WA 98271-4743
Phone (360) 454-1900
3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5442
Hospital & facility affiliations
- Providence at Home With Compassus, Snohomish County
- Providence Regional Medical Center Everett
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10005326 | WA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Care Washington PLLC | Current | Accepting new patients | |
| Optum Care Washington PLLC | Current | Accepting new patients | |
| Optum Care Washington PLLC | Past | Accepting new patients |
Locations
9924 NE 185th St
Ste 215
Bothell, WA 98011
Phone (425) 595-3830
3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903
1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903
Interoperability endpoints
- jibsen17152@direct.tecmc.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.
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1831186766
-
- Rehabilitation Clinic/Center
- Glenview, IL
- NPI 1346368248
-
- Durable Medical Equipment & Medical Supplies
- Marysville, WA
- NPI 1194428425
-
- Ambulatory Surgical Clinic/Center
- Everett, WA
- NPI 1154318103
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Everett, WA
- NPI 1720800857
-
- Hospitalist Physician
- Everett, WA
- NPI 1649615220
-
- General Acute Care Hospital
- Everett, WA
- NPI 1700037801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538611200000",
"number": "1831372622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1019 112TH ST SW",
"city": "EVERETT",
"state": "WA",
"postal_code": "98204",
"telephone_number": "425-551-6200",
"fax_number": "425-551-6017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 HOYT AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014918",
"telephone_number": "425-339-5446",
"fax_number": "425-303-3091"
}
],
"practiceLocations": [
{
"address_1": "1019 112th St SW",
"address_purpose": "LOCATION",
"city": "Everett",
"state": "WA",
"postal_code": "98204",
"country_code": "US",
"telephone_number": "425-551-6200",
"fax_number": "425-551-6017",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IBSEN",
"first_name": "JANELLE",
"middle_name": "M",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-14",
"last_updated": "2018-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA10005326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.