Andrea N Martin, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Shelton, WA
NPI 1104189711 · NPPES record last updated Apr 3, 2017
Key facts
- NPI
- 1104189711
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- MD60636201 (WA)
- Practice address
- 2300 Kati CT
Suite C
Shelton, WA 98584-1900 - Phone
- (360) 426-0955
- NPI assigned
- Jun 19, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Public Hospital District No 1 of Mason County
Practice addresses (Care Compare)
2300 Kati CT
Shelton, WA 98584-1926
901 Mountain View Dr
Shelton, WA 98584-4401
Phone (360) 426-1611
Hospital & facility affiliations
- Mason General Hospital & Family of Clinics
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161104001205 | WA | Practitioner - Obstetrics/Gynecology | 3072815745 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60636201 | WA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Public Hospital District No 1 of Mason County Wa | Current |
Accepting new patients | |
| Public Hospital District No 1 of Mason County | Current |
Accepting new patients | |
| Public Hospital District No 1 of Mason County | Current | Accepting new patients |
Locations
2300 Kati Ct
Ste C
Shelton, WA 98584
Phone (360) 426-0955
2300 Kati Ct
Ste A
Shelton, WA 98584
Phone (360) 426-0955
1701 N 13th St
Shelton, WA 98584
Phone (360) 426-2653
901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD60636201 | WA | Yes |
Addresses
Primary practice location
2300 Kati CT
Suite C
Shelton, WA 98584-1900
Mailing address
2300 Kati CT
Suite C
Shelton, WA 98584-1900
Phone (360) 426-0955
Other providers in Shelton, WA
- Lisa J Mallott
- Kaci Marsh
- Michael Marshall
- Carey R Martens
- Santa Selena Martin-Bautista
- Erin Kim Martin
- Erin Martinache
- Mary M Knight School District
- Mason Co FPD 11
- Mason County
All providers in Shelton, WA · Obstetrics & Gynecology Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.