Individual provider Active NPI

Jeffrey H. Gelgisser, M.D.

  • Family Medicine Physician
  • Redmond, WA
National Provider Identifier
1871641175
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00021278 Issued in WA
Practice address
15809 Bear Creek Pkwy Ste 100
Redmond, WA 98052-1542
Phone
(425) 882-6100
NPI assigned
Jan 5, 2007
Last updated
Apr 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00021278 WA Primary

Addresses

Primary practice location

15809 Bear Creek Pkwy Ste 100
Redmond, WA 98052-1542

Mailing address

15809 Bear Creek Pkwy Ste 100
Redmond, WA 98052-1542
Phone (425) 882-6100

Other practice location 1

2701 156th Ave NE
Redmond, WA 98052-5513
Phone (425) 883-5020

Other identifiers 2

IdentifierTypeStateIssuer
232935OtherWAL&I
1040591MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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
I20090519000248 WA Practitioner - Family Practice 4082763206 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00021278WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Apr 8, 2009 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Apr 8, 2009 Accepting new patients

Locations

15809 Bear Creek Pkwy
Ste 100
Redmond, WA 98052
Phone (425) 882-6100

2701 156th Ave NE
Redmond, WA 98052
Phone (425) 883-5020

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: jgelgisser20094@ghc.direct-ci.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1871641175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15809 BEAR CREEK PKWY STE 100",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980521542",
            "telephone_number": "425-882-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15809 BEAR CREEK PKWY STE 100",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980521542",
            "telephone_number": "425-882-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 156th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980525513",
            "country_code": "US",
            "telephone_number": "425-883-5020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GELGISSER",
        "first_name": "JEFFREY",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00021278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "232935",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1040591",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "15809 Bear Creek Pkwy Ste 100",
            "city": "Redmond",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980521542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.