Active NPI
Andrew Phillip Hyatt, DO
- Family Medicine Physician
- Washington, DC
National Provider Identifier
1073509519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0102202598
- Practice address
- Sa-1 RM L201
2401 E Street NW
Washington, DC 20520-0001 - Phone
- (801) 615-5530
- NPI assigned
- Sep 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0102202598 | VA | Primary |
Addresses
Primary practice location
Sa-1 RM L201
2401 E Street NW
Washington, DC 20520-0001
Mailing address
145 N 170 E
Orem, UT 84057-5527
Phone (801) 615-5530
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 150162 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102202598 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pendleton Family Medicine LLC | Family Medicine | Past | Accepting new patients |
| Praxis Health, PC | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60460
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Pendleton, OR
- NPI 1285765883
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304640000000",
"number": "1073509519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 N 170 E",
"city": "OREM",
"state": "UT",
"postal_code": "840575527",
"telephone_number": "801-615-5530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SA-1 RM L201",
"address_2": "2401 E STREET NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "205200001",
"telephone_number": "801-615-5530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HYATT",
"first_name": "ANDREW",
"middle_name": "PHILLIP",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-20",
"last_updated": "2011-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0102202598",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "150162",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.