Kurt Sandine, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00044314 Issued in WA

Practice address

3928 Pacific Ave SE
Lacey, WA 98503-1109

Phone

(360) 455-1350

Fax

(360) 455-5354

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Loyola University of Chicago, Stritch School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capital Medical Center Physicians LLCGroup PAC ID 3678639879, 59 clinicians

Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence at Home With Compassus, Puget Sound South Hospice, Lacey, WA, CCN 501511
• Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

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

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.

• Capital Medical Center Physicians LLC

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1629214283
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment Care Compare group NPD
• Tumwater Family Practice Clinic

  • Family Medicine Physician
  • Tumwater, WA
  • NPI 1881638559
  Medicare reassignment NPD
• Capital Medical Center Physicians LLC

  • Internal Medicine Physician
  • Montesano, WA
  • NPI 1710744792
  NPD
• Capital Medical Center Physicians LLC

  • Family Medicine Physician
  • Lacey, WA
  • NPI 1649037623
  NPD (past)

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

• CP Sound Wa, LLC

  • Community Based Hospice Care Agency
  • Lacey, WA
  • NPI 1659193795
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997
  Care Compare affiliation

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164527206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 MCCORMICK ST SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011738",
            "telephone_number": "360-866-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3928 PACIFIC AVE SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031109",
            "telephone_number": "360-455-1350",
            "fax_number": "360-455-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDINE",
        "first_name": "KURT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00044314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lanice Sampson-Hall
• Claire Samuels
• Kimberly Michelle Sanborn, LMHCA
• Sand and Stone Counseling PLLC
• Steven Lynn Sandifer, D.C.
• Janet Anonuevo Sanford
• Ryan Wayne Sanford, RBT
• Koushik Varma Sangaraju
• Joshua Santiago
• Ross Jagger Sapp, D.D.S.

• Family Medicine Physician in Lacey, WA
• Providers in Lacey, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.