Individual provider Active NPI

Jennifer Strong Achilles, MD

  • Pediatrics Physician
  • Seattle, WA
National Provider Identifier
1891965133
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60207341 Issued in WA
Practice address
747 Broadway
Seattle, WA 98122-4379
Phone
(206) 215-2700
Fax
(206) 215-3101
NPI assigned
Mar 3, 2008
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20150910002334 NM Practitioner - Pediatric Medicine 4587738091 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60207341WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Miguel Clinic Corp CurrentSince Mar 1, 2021 Accepting new patients
Presbyterian Healthcare Services Pediatrics CurrentSince Oct 1, 2022 Accepting new patients
Presbyterian Healthcare Services CurrentSince Oct 1, 2022 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340

104 Legion Dr
Ste 4
Las Vegas, NM 87701
Phone (505) 426-3780

108 Legion Dr
Ste D
Las Vegas, NM 87701
Phone (505) 425-3569

Interoperability endpoints

  • Direct secure messaging: jachille@yourcarecommunity.org
  • Direct secure messaging: jachilles220384@direct.phs.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD60207341 WA Primary

Addresses

NPPES NPI Registry

Primary practice location

747 Broadway
Seattle, WA 98122-4379

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 20, 2013.

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1891965133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224379",
            "telephone_number": "206-215-2700",
            "fax_number": "206-215-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACHILLES",
        "first_name": "JENNIFER",
        "middle_name": "STRONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60207341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.