NPIMap

Individual provider Active NPI

Andrea Marie Repphun, MD

  • Family Medicine Physician
  • Tumwater, WA
National Provider Identifier
1043383136
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00040230 Issued in WA
Practice address
150 Dennis St SW
Tumwater, WA 98501-5459
Phone
(360) 754-6367
Fax
(360) 754-6429
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00040230 WA Primary

Addresses

Primary practice location

150 Dennis St SW
Tumwater, WA 98501-5459

Mailing address

150 Dennis St SW
Tumwater, WA 98501-5459
Phone (360) 754-6367

Other identifiers 2

IdentifierTypeStateIssuer
1043383136OtherWANPI
8286536MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803001369 WA Practitioner - General Practice 6901953587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Missouri, Kansas City, School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Capital Medical Center Physicians LLCGroup PAC ID 3678639879, 59 clinicians

Practice addresses (Care Compare)

150 Dennis St SW
A
Tumwater, WA 98501-5459
Phone (360) 754-6367

3920 Capital Mall Dr SW
Suite 200
Olympia, WA 98502-8701
Phone (360) 459-7282

Hospital & facility affiliations

  • Careage Home Health Home health agency, Dupont, WA, CCN 507129
  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Capital Medical Center Hospital, Olympia, WA, CCN 500139
  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00040230WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Medical Center Physicians LLC CurrentSince Apr 1, 2024 Accepting new patients
Capital Medical Center Physicians LLC Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Tumwater Family Practice Clinic Family Medicine CurrentSince Nov 1, 2013 Accepting new patients
Capital Medical Center Physicians LLC Family Medicine Past Accepting new patients

Locations

5130 Corporate Center Ct SE
Lacey, WA 98503
Phone (360) 413-8600

3920 Capital Mall Dr SW
Ste 200
Olympia, WA 98502
Phone (360) 459-7282

150 Dennis St SW
#0
Tumwater, WA 98501

150 Dennis St SW
#A
Tumwater, WA 98501
Phone (360) 754-6367

150 Dennis St SW
Tumwater, WA 98501
Phone (360) 754-6367

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDHGAA

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.

Hospital & facility affiliations 8

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1043383136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 DENNIS ST SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985015459",
            "telephone_number": "360-754-6367",
            "fax_number": "360-754-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 DENNIS ST SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985015459",
            "telephone_number": "360-754-6367",
            "fax_number": "360-754-6429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REPPHUN",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00040230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043383136",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8286536",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tumwater, WA

Sources for this page

Verify at the official NPI Registry.