Deactivated NPI 1992883847 Deactivated / Inactive NPI Male Practitioner

Dr. Jourdan R Gottlieb , MD

Specialist • Seattle, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jourdan Gottlieb has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 01, 2006

NPI Deactivation Date August 06, 2026

Total Practice Duration ~20 Years of Practice (2006 – 2026)

Professional Overview & Biography Verified Profile Summary

Dr. Jourdan Gottlieb, MD was a registered Specialist practicing in Seattle, WA. Throughout an active medical career spanning 20 years, Dr. Gottlieb provided care at the practice location at 1600 E JEFFERSON ST until profile deactivation on 2026-08-06.

Historical Medicare Part B clinical services included creation of muscle graft to trunk, initial hospital inpatient care per day, removal of muscle and/or tissue. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1600 E Jefferson St
Ste # 501

Seattle, WA 981225698

Telephone 2063202270

Fax 2063202101

Associated Practice Facility / Clinic

🏢 Dynacare Northwest, Inc Facility NPI 1669459525

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Seattle, WA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 35.8 Yrs

State Avg: 35.4 Yrs

Regional Practice Density

366 Specialists

Practicing in Seattle, WA (2751 Statewide)

Telehealth Adoption Rate

0.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

75.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
15734 Creation of muscle graft to trunk	31	11	$4506.00	$1090.83
99221 Initial hospital inpatient care per day, typically 30 minutes	15	15	$276.00	$86.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99221 Initial hospital inpatient care per day, typically 30 minutes	14	14	$258.00	$89.16

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
15734 Creation of muscle graft to trunk	40	14	$3918.60	$1150.02
99221 Initial hospital inpatient care per day, typically 30 minutes	20	19	$258.00	$103.60

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	108	11	$141.00	$60.05
15734 Creation of muscle graft to trunk	58	21	$3871.00	$1161.22
99221 Initial hospital inpatient care per day, typically 30 minutes	19	19	$253.00	$108.67
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	13	11	$592.00	$104.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	182	14	$141.00	$61.67
15734 Creation of muscle graft to trunk	96	32	$3840.00	$1115.38
99221 Initial hospital inpatient care per day, typically 30 minutes	36	34	$251.00	$110.59
99231 Follow-up hospital inpatient care per day, typically 15 minutes	29	13	$108.00	$42.58
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	20	14	$592.00	$98.89
15100 Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less	19	13	$1824.00	$613.69
15002 Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children)	17	11	$575.00	$229.57

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	221	17	$107.00	$60.45
11047 Removal of bone, each additional 20.0 sq cm or less	160	11	$184.00	$106.95
15734 Creation of muscle graft to trunk	136	38	$3364.56	$1097.18
99221 Initial hospital inpatient care per day, typically 30 minutes	35	35	$244.00	$106.81
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	27	19	$586.00	$115.50
15002 Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children)	23	16	$561.00	$241.06
15100 Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less	23	16	$1759.00	$668.00
11044 Removal of bone, 20.0 sq cm or less	16	11	$587.00	$155.22
99231 Follow-up hospital inpatient care per day, typically 15 minutes	16	11	$106.00	$41.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11047 Removal of bone, each additional 20.0 sq cm or less	273	23	$181.00	$102.83
15734 Creation of muscle graft to trunk	170	56	$3293.00	$1060.38
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	125	15	$105.00	$55.93
99221 Initial hospital inpatient care per day, typically 30 minutes	59	55	$241.00	$100.27
15946 Removal of pressure sore and lower pelvic bone in preparation of muscle flap or skin graft closure	48	13	$3880.44	$1430.00
15738 Muscle flap wound repair of leg	37	21	$3074.00	$943.41
15100 Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less	33	25	$1734.00	$530.45
11044 Removal of bone, 20.0 sq cm or less	32	23	$579.00	$149.74
15002 Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children)	27	23	$553.00	$228.69
15004 Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less	23	18	$678.00	$244.43
15120 Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)	22	17	$1908.00	$400.30
99231 Follow-up hospital inpatient care per day, typically 15 minutes	20	14	$98.00	$40.16
13160 Second repair of surgical wound	18	13	$1963.00	$566.07
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	17	15	$578.00	$95.54
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	17	14	$2233.00	$723.54
15937 Removal of pressure sore and bone at sacrum in preparation of muscle flap or skin graft	16	14	$2512.00	$705.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	126	13	$101.00	$55.42
15734 Creation of muscle graft to trunk	103	36	$3178.00	$832.88
99221 Initial hospital inpatient care per day, typically 30 minutes	67	65	$233.00	$96.91
15738 Muscle flap wound repair of leg	31	17	$2967.00	$834.12
15946 Removal of pressure sore and lower pelvic bone in preparation of muscle flap or skin graft closure	27	12	$3825.00	$1496.18
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	25	20	$558.00	$85.09
15100 Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less	22	20	$1674.00	$538.67
15002 Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children)	21	19	$534.00	$233.02
99231 Follow-up hospital inpatient care per day, typically 15 minutes	20	17	$95.00	$38.85
15120 Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)	18	15	$1842.00	$421.05
15004 Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less	17	14	$654.00	$277.68
13160 Second repair of surgical wound	17	17	$1895.00	$583.13

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License WA MD00023270

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

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Otolaryngology

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Doctor of Medicine (M.D.)

Dr. Christopher Famy , MD

Psychiatry & Neurology - Psychiatry

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Doctor of Medicine (M.D.)

Dr. Amanda Steen , MD

Physical Medicine & Rehabilitation

NPI 1043463565

Doctor of Medicine (M.D.)

Dr. Jeffrey Moo , MD

Physical Medicine & Rehabilitation

NPI 1053376350

Doctor of Medicine (M.D.)

Dr. Jeffrey Reiter , PhD

Psychologist

NPI 1083614861

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events

⚠️

NPI Profile Deactivated August 06, 2026

Record deactivated on August 06, 2026

📍

Updated Practice Location January 06, 2020

Registered at 500 17TH AVE, SEATTLE, WA 981225711 (Tel: 2063202580)

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Updated Business Mailing Address January 06, 2020

Registered at PO BOX 25608, SALT LAKE CITY, UT 841250608 (Tel: 2063204476)

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Provider Name / Credentials Updated January 06, 2020

Recorded as JOURDAN GOTTLIEB, MD

✅

NPI Profile Active March 17, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location March 17, 2011

Registered at 1600 E JEFFERSON ST, STE # 501, SEATTLE, WA 981225698 (Tel: 2063202270)

📍

Updated Business Mailing Address March 17, 2011

Registered at 1600 E JEFFERSON ST, STE # 501, SEATTLE, WA 981225698 (Tel: 2063202270)

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Provider Name / Credentials Updated March 17, 2011

Recorded as JOURDAN GOTTLIEB, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2011

Specialist (License #MD00023270 in WA)

🟢

Initial NPI Registration & Enumeration November 01, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992883847

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: November 01, 2006

Last Update: March 17, 2011

Deactivation Date: August 06, 2026

Update or Correct Profile

Mailing Address

1600 E Jefferson St, Ste # 501

Seattle, WA 981225698

Phone: 2063202270

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.