DR. ELLEN LACKERMAN M.D.
NPI 1710976485
Family Medicine in Seattle, WA
About Dr. Ellen Lackerman M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ELLEN LACKERMAN M.D. (NPI 1710976485) is an individual family medicine provider in Seattle, Washington, licensed in Washington (MD00023806) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Ellen Lackerman M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Ellen Lackerman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Renton, WA 98055
- Reassigned Medicare billing, Washington enrollment
- 291 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98144 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ellen Lackerman's NPI number?
The NPI number for Ellen Lackerman is 1710976485. It was assigned to this individual provider in the NPPES registry on October 17, 2005.
Where is Ellen Lackerman located?
Ellen Lackerman practices at 1200 12th Ave S, Seattle, WA 98144. The listed phone number is (206) 326-2400.
What is Ellen Lackerman's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Ellen Lackerman enrolled in Medicare?
Yes. Ellen Lackerman is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Ellen Lackerman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ellen Lackerman reassigns Medicare benefits to Pacmed Clinics (Renton, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ellen Lackerman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Ellen Lackerman was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Ellen Lackerman, M.D. · NPI 1710976485
Family Medicine physician in Seattle, Washington. Individual provider, active in the CMS NPPES registry since October 17, 2005.
## Identity
- **NPI:** 1710976485 (Entity type: Individual)
- **Enumerated:** October 17, 2005
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** MD00023806 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 1200 12TH AVE S, Seattle, WA 98144-2712
- **Phone:** (206) 326-2400
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Pacmed Clinics (NPI 1720023641, Renton, WA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 13, 2026
- **Other identifiers:** Medicaid 8131476 (WA)
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Source: [NPI Profile](https://npiprofile.com/npi/1710976485) · Data from the CMS NPPES public registry.