Individual provider Active NPI

Laura E Brandt, PA-C

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1013997899
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60494105 Issued in WA
Practice address
8614 E Mill Plain Blvd
Suite 400
Vancouver, WA 98664-2059
Phone
(360) 254-5267
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0002219 MD
Physician Assistant 363A00000X 60494105 WA Primary

Addresses

Primary practice location

8614 E Mill Plain Blvd
Suite 400
Vancouver, WA 98664-2059

Mailing address

8614 E Mill Plain Blvd
Suite 400
Vancouver, WA 98664-2059
Phone (360) 254-5267

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141015000990 WA Practitioner - Physician Assistant 9335309517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Louisiana State University School of Medicine in Shreveport, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of Southwest Washington, PLLCGroup PAC ID 5496891509, 3 clinicians

Practice addresses (Care Compare)

8614 E Mill Plain Blvd
Suite 400
Vancouver, WA 98664-2092
Phone (360) 254-5267

Merit-based Incentive Payment System (MIPS)

Final score
89.22 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0002219MDMDPhysician Assistant
60494105WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of Maryland PC Past Accepting new patients
Greater Washington Dermatology PA PastSince Dec 1, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1013997899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 E MILL PLAIN BLVD",
            "address_2": "SUITE 400",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986642059",
            "telephone_number": "360-254-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8614 E MILL PLAIN BLVD",
            "address_2": "SUITE 400",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986642059",
            "telephone_number": "360-254-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDT",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002219",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "60494105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.