Individual provider Active NPI

Jaymes Richard Venema, MD

  • Neurology Physician
  • Bothell, WA
National Provider Identifier
1962414375
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
46761 Issued in WA
Practice address
1909 214TH St SE Ste 300
Bothell, WA 98021-4418
Phone
(425) 412-7200
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 46761 WA Primary

Addresses

Primary practice location

1909 214TH St SE Ste 300
Bothell, WA 98021-4418

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 258-3903

Other practice location 1

3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 259-0966

Other identifiers 1

IdentifierTypeStateIssuer
46761OtherWALICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jvenema127363@wm.providencedirect.org

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
I20061010000558 WA Practitioner - Neurology 2365448685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Medical College of Pennsylvania, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

1909 214TH St SE
Suite 300
Bothell, WA 98021-4418
Phone (425) 412-7200

Hospital & facility affiliations

  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46761WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics Current Accepting new patients
Pacmed Clinics CurrentSince Dec 4, 2016 Accepting new patients

Locations

1909 214th St SE
Ste 300
Bothell, WA 98021
Phone (425) 412-6335

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

601 S Carr Rd
Ste 100
Renton, WA 98055
Phone (425) 227-3700

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

Interoperability endpoints

  • Direct secure messaging: jvenema127363@wm.providencedirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1962414375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-258-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 214TH ST SE STE 300",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214418",
            "telephone_number": "425-412-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Hoyt Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982014918",
            "country_code": "US",
            "telephone_number": "425-259-0966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENEMA",
        "first_name": "JAYMES",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "46761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "46761",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvenema127363@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "1909 214th St SE Ste 300",
            "city": "Bothell",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980214418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

Verify at the official NPI Registry.