ANDREW RYAN JACKENHEIMER (M.D.) – Psychiatry Physician, NPI 1346569928
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
710 PSYCHIATRY in WA
Provider Addresses for ANDREW RYAN JACKENHEIMER (M.D.)
500 17TH AVE
SEATTLE, WA 981225711
Phone: (206) 320-7288
Fax: (206) 320-7289
Type: Location
PO BOX 25608
SALT LAKE CITY, UT 841250608
Phone: (206) 320-4476
Fax: (206) 568-7043
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 37 Open Payments records for all available years, with a total value of $792.
Total Amount is formed as General ($792) + Research ($0) + Ownership ($0) = $792.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($133).
Total Amount
$792
General + Research + Ownership
Payments
37
Total payment records
General Amount
$792
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-08-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170825003308 | I | Psychiatry | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90792 | Psychiatric diagnostic evaluation with medical services | 13 | 13 | $0 |
Insurance plans in this area (ZIP 98122)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | WA | |
| P S Y C H I A T R Y | WA | |
| P S Y C H I A T R Y | MO | |
| P S Y C H I A T R Y | WA | |
| Nurse Practitioner | SC | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | WA |
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