DR. BENJAMIN WELLS JADERHOLM D.O.
NPI 1093128027
Family Medicine in Liberty Lake, WA

Q: What is Benjamin Jaderholm's NPI number?

The NPI number for Benjamin Jaderholm is 1093128027. It was assigned to this individual provider in the NPPES registry on June 6, 2014.

Q: What is Benjamin Jaderholm's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since June 06, 2014PECOS EnrolledAccepts Medicare Assignment

1326 N STANFORD LN, LIBERTY LAKE, WA 99019(509) 838-2531(509) 755-6580 Get Directions Write a Review

NPPES record last updated: April 27, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 27, 2018, Jul 6, 2017, May 16, 2016 and 1 more (4 updates tracked since 2016).

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About Dr. Benjamin Wells Jaderholm D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BENJAMIN WELLS JADERHOLM D.O. (NPI 1093128027) is an individual family medicine provider in Liberty Lake, Washington, licensed in Washington (OP60804314) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS, is affiliated with Kootenai Health, and maintains a secondary practice location in Gallipolis.

NPPES Registry Identity

NPI1093128027

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. BENJAMIN WELLS JADERHOLMCredential: D.O.

Location Address1326 N STANFORD LNLiberty Lake, WA 99019-5034

Mailing AddressPo Box 3649Spokane, WA 99220-3649 · (509) 838-2531

Phone(509) 838-2531

Fax(509) 755-6580

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateJune 6, 2014

Last NPPES UpdateApril 27, 20184 updates tracked since enumeration

✔ NPI 1093128027 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WA · OP60804314

Definition

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 58.007627 (OH)

1326 N STANFORD LN, Liberty Lake, WA 99019

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Secondary Practice Location 1

Location 1100 Jackson PikeGallipolis, OH 45631-1560 · Phone (855) 446-5937 · Fax (740) 446-5448

Other Identifiers 1

Medicaid0159060OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Benjamin Wells Jaderholm D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789980947

PECOS Enrollment IDI20180424001307

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This 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.

496 services236 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An 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.

208 services208 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This 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.

76 services66 patients

Administration of influenza virus vaccine G0008

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.

29 services28 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

25 services25 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

17 services17 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Kootenai Health

Acute Care Hospitals · Coeur D'alene, ID

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number130049

Location2003 Kootenai Health WayCoeur D'alene, ID 83814 · Kootenai County

Emergency services Birthing friendly

Deaconess Medical Center

Acute Care Hospitals · Spokane, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500044

LocationW 800 Fifth AvenueSpokane, WA 99210 · Spokane County

Emergency services Birthing friendly

Multicare Valley Hospital

Acute Care Hospitals · Spokane, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500119

Location12606 East Mission AvenueSpokane, WA 99216 · Spokane County

Emergency services Birthing friendly

Tacoma General Allenmore Hospital

Acute Care Hospitals · Tacoma, WA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500129

Location315 S Mlk Jr WayTacoma, WA 98405 · Pierce County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99019 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 10

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

10 suppliers21 claims68 services$6.36 avg. paid by Medicare

Adhesive remover, wipes, any type, each A4456

DME-Medical/Surgical Supplies · category DA000N

2 suppliers11 claims425 services$0.23 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

5 suppliers14 claims14 services$39.07 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

5 suppliers15 claims15 services$58.95 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

5 suppliers14 claims14 services$18.35 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers20 claims98 services$2.28 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLEN R SEELY MD

Family Medicine