DR. ELLEN LACKERMAN M.D.
NPI 1710976485
Family Medicine in Seattle, WA
NPI Status: Active since October 17, 2005
- Individual
- Female
- Family Medicine
- Accepts Insurance
- PECOS Enrolled
About ELLEN LACKERMAN
This page provides the complete NPI Profile along with additional information for Ellen Lackerman, a primary care provider established in Seattle, Washington with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1710976485 assigned on October 2005. The practitioner's primary taxonomy code is 207Q00000X with license number MD00023806 (WA). The provider is registered as an individual and her NPI record was last updated 18 years ago.
- NPI
- 1710976485
- Provider Name
- DR. ELLEN LACKERMAN M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1200 12TH AVE S SEATTLE, WA 98144
- Location Phone
- (206) 326-2400
- Mailing Address
- 1200 12TH AVE S SEATTLE, WA 98144
- Mailing Phone
- (206) 326-2400
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-17-2005
- Last Update Date
- 07-08-2007
- Code Navigator
A primary care provider (PCP) like Ellen Lackerman sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD00023806
- License State
- WA
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Navigator Bronze 7000 Exchange - PPO
- Navigator Bronze 9200 - PPO
- Navigator Bronze HSA 8050 - PPO
- Navigator Gold 1500 - PPO
- Navigator Gold 1500 Exchange - PPO
- Navigator Gold 500 Exchange - PPO
- Navigator Silver 3500 Exchange - PPO
- Navigator Silver 4000 Exchange - PPO
- Navigator Silver 5000 - PPO
- Navigator Silver HSA 3500 - PPO
- Navigator Standard Expanded Bronze - PPO
- Navigator Standard Gold - PPO
- Navigator Standard Silver - PPO
- PacificSource Oregon Standard Bronze Plan NAV - PPO
- PacificSource Oregon Standard Gold Plan NAV - PPO
- PacificSource Oregon Standard Silver Plan NAV - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State | Identifier Issuer |
---|---|---|---|
F00214 | MEDICARE UPIN (02) | WA | |
8131476 | MEDICAID (05) | WA | |
AB34900 | MEDICARE ID-TYPE UNSPECIFIED (04) | WA |
Medicare Participation & PECOS Enrollment Status
Ellen Lackerman is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Administration of influenza virus vaccine
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Screening 3d breast mammography
Screening mammography
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 13 times for 13 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 18 times for 18 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 33 times for 25 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 78 times for 44 patientsScreening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.
This service was performed 14 times for 14 patientsScreening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.
This service was performed 15 times for 15 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 98144 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $97.43
- Minimum New Patient Price $63.67
- Maximum New Patient Price $189.37
- Average New Patient Copayment $24.35
- Minimum New Patient Copayment $15.91
- Maximum New Patient Copayment $47.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $111
- Minimum Established Patient Price $21.12
- Maximum Established Patient Price $155
- Average Established Patient Copayment $27.75
- Minimum Established Patient Copayment $5.28
- Maximum Established Patient Copayment $38.75
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 7 | 1 | 0 | 9 | 7 | 6 | 4 | 8 | 5 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 7 | 2 | 0 | 18 | 7 | 12 | 4 | 16 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 7 + 2 + 0 + 1 + 8 + 7 + 1 + 2 + 4 + 1 + 6 + 24 = 65 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 65 = 5 | 5 |
The NPI number 1710976485 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1154319796 | DR. VICTORIA E. ALLEN MD Individual | Internal Medicine | 1200 12TH AVE S SEATTLE, WA 98144 (206) 326-2400 |
1003804055 | MS. MARTY R. BABCOCK ARNP Individual | Nurse Practitioner (Primary Care) | 1200 12TH AVE S SEATTLE, WA 98144 (205) 326-2400 |
1508855297 | MS. STEPHANIE F. CLEMENTS PT Individual | Physical Therapist | 1200 12TH AVE S SEATTLE, WA 98144 (206) 324-2600 |
1417946617 | RODNEY TERASAKI MD Individual | Internal Medicine | 1200 12TH AVE S SEATTLE, WA 98144 (206) 326-2400 |
1306835558 | MARJORIE J. WALKER PT Individual | Physical Therapist | 1200 12TH AVE S SEATTLE, WA 98144 (206) 326-2400 |
1568425841 | RICHARD A BEREN MD Individual | Radiology (Diagnostic Radiology) | 1200 12TH AVE S SEATTLE, WA 98144 (509) 747-4455 |
1508829524 | CHRISTOPHER SCOTT KREJCI MD Individual | Radiology (Diagnostic Radiology) | 1200 12TH AVE S SEATTLE, WA 98144 (509) 747-4455 |
1699738658 | JUSTIN P SMITH MD Individual | Radiology (Nuclear Radiology) | 1200 12TH AVE S SEATTLE, WA 98144 (509) 747-4455 |
1871542928 | STEVEN Y SOHN MD Individual | Radiology (Diagnostic Radiology) | 1200 12TH AVE S SEATTLE, WA 98144 (509) 747-4455 |
1538100581 | PACMED CLINICS Organization | Clinic/Center (Multi-Specialty) | 1200 12TH AVE S SEATTLE, WA 98144 (206) 326-2400 |
1437191004 | NORBERT K YEE MD Individual | Radiology (Diagnostic Radiology) | 1200 12TH AVE S SEATTLE, WA 98144 (509) 747-4455 |
1225060221 | CONNIE L EMERSON MD Individual | Radiology (Diagnostic Radiology) | 1200 12TH AVE S SEATTLE, WA 98144 (509) 747-4455 |
1962418814 | GREGORY P LEWIS MD Individual | Radiology (Diagnostic Radiology) | 1200 12TH AVE S SEATTLE, WA 98144 (509) 747-4455 |
1962511709 | MAI T RUSSELL MD Individual | Radiology (Neuroradiology) | 1200 12TH AVE S SEATTLE, WA 98144 (509) 747-4455 |
1265512214 | MS. RIMA S. ZIKAS MPT Individual | Physical Therapist | 1200 12TH AVE S SEATTLE, WA 98144 (206) 326-2400 |
1376695858 | GINGER RAE RUDDY MD Individual | Family Medicine | 1200 12TH AVE S SEATTLE, WA 98144 (206) 326-2400 |
1083754154 | THOMAS J. YETMAN M.D. Individual | Obstetrics & Gynecology (Obstetrics) | 1200 12TH AVE S QUARTERS 6-7 SEATTLE, WA 98144 (206) 621-4316 |
1235394461 | DYNACARE NORTHWEST INC Organization | Clinical Medical Laboratory | 1200 12TH AVE S SEATTLE, WA 98144 (206) 326-2400 |
1245463793 | LAURA B BOGH Individual | Physical Therapist | 1200 12TH AVE S SEATTLE, WA 98144 (206) 326-2400 |
1770812448 | GLADYS R ROMASANTA ARNP Individual | Nurse Practitioner | 1200 12TH AVE S SEATTLE, WA 98144 (206) 326-2400 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710976485, enumerated in the NPI registry as an "individual" on October 17, 2005
The provider is located at 1200 12th Ave S Seattle, Wa 98144 and the phone number is (206) 326-2400
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: PacificSource Health Plans, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $97.43 with an average copayment of $24.35 for new patient appointments. Established patients should expect a typical charge of $111 and an average copayment of 27.75. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Administration of influenza virus vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Screening 3d breast mammography and Screening mammography.
This NPI record was last updated on October 17, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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