Individual provider Active NPI

Jeffrey Wayne Gertner, MD

  • Dermatology Physician
  • Poulsbo, WA
National Provider Identifier
1912980624
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD61659432 Issued in WA
Practice address
21800 Marketplace NW Ste 103
Poulsbo, WA 98370-6667
Phone
(360) 291-5700
Fax
(360) 637-0863
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X MD61659432 WA
Dermatology Physician 207N00000X MD61659432 WA Primary

Addresses

Primary practice location

21800 Marketplace NW Ste 103
Poulsbo, WA 98370-6667

Mailing address

21800 Marketplace NW Ste 103
Poulsbo, WA 98370-6667
Phone (360) 291-5700

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
I20250806004023 WA Practitioner - Dermatology 2466829940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

21800 Market PL NW
Suite 103
Poulsbo, WA 98370-6667
Phone (360) 291-5700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision21
Removal of skin lesions128
Removal or shaving of skin growth1-10
Skin biopsy55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61659432WAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Smithcare: General Dermatology, Mohs Surgery & Aesthetics PLLC Dermatology CurrentSince Aug 1, 2025 Accepting new patients

Locations

21800 Market Pl NW
Ste 103
Poulsbo, WA 98370
Phone (360) 291-5700

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.

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1912980624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21800 MARKETPLACE NW STE 103",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706667",
            "telephone_number": "360-291-5700",
            "fax_number": "360-637-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21800 MARKETPLACE NW STE 103",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706667",
            "telephone_number": "360-291-5700",
            "fax_number": "360-637-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERTNER",
        "first_name": "JEFFREY",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "WA",
            "license": "MD61659432",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD61659432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

Verify at the official NPI Registry.