Fredrick Sungjae An, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OP61580368 Issued in WA

Practice address

413 Lilly Rd NE
Olympia, WA 98506-5166

Phone

(360) 491-9480

Fax

(360) 456-2413

NPI assigned

May 1, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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

Internal Medicine

Education

College of Osteo Med of the Pacific at Pomona, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fan4565461@ghc.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment Care Compare group NPD
• Franciscan Medical Group

  dba Westsound Orthopaedics A part of the Franciscan Medical Group

  • Orthopaedic Surgery Physician
  • Silverdale, WA
  • NPI 1093165334
  Medicare reassignment NPD
• Franciscan Medical Group

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1366539421

  Internal Medicine

  NPD
• Kaiser Foundation Health Plan of Washington

  dba Everett Medical Center

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1669619870
  NPD

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1194991901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065166",
            "telephone_number": "360-491-9480",
            "fax_number": "360-456-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065166",
            "telephone_number": "360-491-9480",
            "fax_number": "360-456-2413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24800 SE Stark St",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970303378",
            "country_code": "US",
            "telephone_number": "503-413-8407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1717 S J St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054933",
            "country_code": "US",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AN",
        "first_name": "FREDRICK",
        "middle_name": "SUNGJAE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-01",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO29350",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "OP61580368",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP61580368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2013154",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "413 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Catherine Elizabeth Amos, LMHC
• Abigail Amundson, SUDPT
• Brooke M Amyx, LICSW, CDP
• Amber Rose An, DO
• Changmin An
• Mike An
• Rachna Anand, DO
• Jessica Anastasio
• Keiron Anatu
• Teresa A Anders, A.R.N.P.

• Internal Medicine Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.