NPIMap

Individual provider Active NPI

Jack J Jorgenson, MD

  • Family Medicine Physician
  • Shoreline, WA
National Provider Identifier
1922503168
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD70005153 Issued in WA
Practice address
604 NW Richmond Beach Rd
Shoreline, WA 98177-3122
Phone
(206) 533-2900
Fax
(206) 533-2901
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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 MD70005153 WA Primary

Addresses

Primary practice location

604 NW Richmond Beach Rd
Shoreline, WA 98177-3122

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2349648MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210616002176 WI Practitioner - Family Practice 2163857046 Reassigns benefits to 2 organizations
I20250913000585 WA Practitioner - Family Practice 2163857046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

201 N Mayfair Rd
Wauwatosa, WI 53226-4216

3501 E Ramsey Ave
Cudahy, WI 53110-3009
Phone (414) 769-6000

604 NW Richmond Beach Rd
Shoreline, WA 98177-3122
Phone (206) 533-2900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD70005153WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services CurrentSince Sep 8, 2025 Accepting new patients
The Medical College of Wisconsin, Inc. Family Medicine CurrentSince Sep 1, 2021 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Family Medicine CurrentSince Jun 8, 2021 Accepting new patients
Swedish Health Services Family Medicine Current Accepting new patients
Swedish Health Services Family Medicine CurrentSince Sep 8, 2025 Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

1801 Lind Ave SW
Renton, WA 98057

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

604 NW Richmond Beach Rd
Shoreline, WA 98177
Phone (206) 533-2900

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

1121 E North Ave
Milwaukee, WI 53212
Phone (414) 267-6500

8020 S Howell Ave
Oak Creek, WI 53154
Phone (414) 647-3920

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 5

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1922503168",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 NW RICHMOND BEACH RD",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773122",
            "telephone_number": "206-533-2900",
            "fax_number": "206-533-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSON",
        "first_name": "JACK",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD70005153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2349648",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

Verify at the official NPI Registry.