Individual provider Active NPI

Alanna Lauren Sandack, D.O.

  • General Practice Physician
  • Bremerton, WA
National Provider Identifier
1013127323
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OP00002318 Issued in WA
Practice address
1520 NE Riddell Rd Ste 110
Bremerton, WA 98310-3005
Phone
(360) 228-7246
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X OP00002318 WA
General Practice Physician 208D00000X 268740 NY
General Practice Physician 208D00000X 02003485B IN
General Practice Physician 208D00000X 02003485A IN
General Practice Physician 208D00000X OP00002318 WA Primary

Addresses

Primary practice location

1520 NE Riddell Rd Ste 110
Bremerton, WA 98310-3005

Mailing address

1520 NE Riddell Rd Ste 110
Bremerton, WA 98310-3005
Phone (360) 228-7246

Other practice location 1

505 Washington Ave S
Kent, WA 98032-5709
Phone (253) 833-7444

Other practice location 2

1701 18th Ave S
Seattle, WA 98144-4317
Phone (253) 833-7444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210126002573 WA Practitioner - General Practice 9234162124 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Cities Counseling and ConsultationGroup PAC ID 6406842053, 53 clinicians

Practice addresses (Care Compare)

505 Washington Ave S
Kent, WA 98032-5709
Phone (253) 833-7444

Hospital & facility affiliations

  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02003485AINMDGeneral Practice Physician
02003485BINMDGeneral Practice Physician
268740NYMDGeneral Practice Physician
OP00002318WAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Cities Counseling and Consultation CurrentSince Sep 20, 2021 Accepting new patients
Baart Behavioral Health Services, Inc. CurrentSince Mar 16, 2026 Accepting new patients
Signify Health Medical Associates, PLLC General Practice CurrentSince Dec 1, 2020 Accepting new patients
F&M Healthcare, LLC CurrentSince Dec 1, 2023 Accepting new patients
Baart Behavioral Health Services, Inc. PastSince Feb 12, 2023 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

2704 I St NE
Auburn, WA 98002
Phone (253) 876-3415

505 Washington Ave S
Kent, WA 98032
Phone (253) 652-7294

325 W Gowe St
Kent, WA 98032

711 Capitol Way S
Ste 204
Olympia, WA 98501
Phone (602) 499-5303

1701 18th Ave S
Seattle, WA 98144
Phone (206) 731-7210

6824 19th St W
#256
University Place, WA 98466
Phone (253) 777-1423

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1013127323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 NE RIDDELL RD STE 110",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103005",
            "telephone_number": "360-228-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 NE RIDDELL RD STE 110",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103005",
            "telephone_number": "360-228-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Washington Ave S",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "WA",
            "postal_code": "980325709",
            "country_code": "US",
            "telephone_number": "253-833-7444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 18th Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981444317",
            "country_code": "US",
            "telephone_number": "253-833-7444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDACK",
        "first_name": "ALANNA",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "OP00002318",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "268740",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02003485B",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02003485A",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "OP00002318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.