Individual provider Active NPI

Jacquelyn Lorie, PA-C

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1982062352
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60640398 Issued in WA
Practice address
1221 Madison St Ste 600 Seattle
Seattle, WA 98104-3588
Phone
(206) 215-5900
Fax
(206) 215-2250
NPI assigned
Feb 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60640398 WA Primary

Addresses

Primary practice location

1221 Madison St Ste 600 Seattle
Seattle, WA 98104-3588

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170425000143 TX Practitioner - Physician Assistant 4981995636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Referral ServiceGroup PAC ID 7911801410, 2,728 clinicians

Practice addresses (Care Compare)

13900 Katy Fwy
Houston, TX 77079-1012
Phone (713) 563-9600

2130 W Holcombe Blvd
Univ of TX M D Ande Life Sciences Plaza
Houston, TX 77030-4009
Phone (713) 592-5433

Hospital & facility affiliations

  • University of Texas M D Anderson Cancer Center Hospital, Houston, TX, CCN 450076

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Quality
70.82
Promoting interoperability
100
Improvement activities
40
Cost
67.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60640398WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Woodlands Pain Consultants,PA PastSince Aug 16, 2020 Accepting new patients

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 1

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": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1982062352",
    "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": "1221 MADISON ST STE 600 SEATTLE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043588",
            "telephone_number": "206-215-5900",
            "fax_number": "206-215-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORIE",
        "first_name": "JACQUELYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60640398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.