Active NPI
Jeffrey Lyle Summe, D.O.
- Family Medicine Physician
- Lynnwood, WA
National Provider Identifier
1861409732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1198
- Practice address
- 19031 33Rd Ave W
Suite 314
Lynnwood, WA 98036-4731 - Phone
- (425) 744-0709
- Fax
- (425) 771-1470
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1198 | WA | Primary |
Addresses
Primary practice location
19031 33Rd Ave W
Suite 314
Lynnwood, WA 98036-4731
Mailing address
19031 33Rd Ave W
Suite 314
Lynnwood, WA 98036-4731
Phone (425) 744-0709
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1301647 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 10, 2025 through Mar 10, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summe Medical Clinic | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Ed,Monds, WA
- NPI 1831311141
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861409732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19031 33RD AVE W",
"address_2": "SUITE 314",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364731",
"telephone_number": "425-744-0709",
"fax_number": "425-771-1470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19031 33RD AVE W",
"address_2": "SUITE 314",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364731",
"telephone_number": "425-744-0709",
"fax_number": "425-771-1470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMME",
"first_name": "JEFFREY",
"middle_name": "LYLE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "1198",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1301647",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.