Individual provider Active NPI

Andrew Paul Patel, M.D.

  • Family Medicine Physician
  • Fulton, MO
National Provider Identifier
1235579756
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60658462 Issued in WA
Practice address
110 N Hospital Dr
Fulton, MO 65251-2511
Phone
(573) 642-5911
Fax
(573) 642-3015
NPI assigned
Jun 28, 2013
Last updated
Jun 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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 MD60658462 WA Primary

Addresses

Primary practice location

110 N Hospital Dr
Fulton, MO 65251-2511

Mailing address

1620 Cooper Point Rd SW
Ma303, Dc032.00
Olympia, WA 98502-5736
Phone (573) 884-2912

Other practice location 1

1620 Cooper Point Rd SW
Olympia, WA 98502-5736
Phone (360) 486-6710

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apatel665602@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160921000629 WA Practitioner - Family Practice 3375787989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services - WashingtonGroup PAC ID 2365427556, 9 clinicians

Practice addresses (Care Compare)

1620 Cooper Point Rd SW
Olympia, WA 98502-5736
Phone (306) 486-6710

18313 Paulson St SW
Rochester, WA 98579-9262
Phone (360) 827-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60658462WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Family Medicine CurrentSince Sep 1, 2016 Accepting new patients
Providence Health & Services - Washington CurrentSince Jan 27, 2025 Accepting new patients
Capital Clubhouse Past Accepting new patients

Locations

1018 Capitol Way S
Ste 300
Olympia, WA 98501
Phone (360) 486-6508

1620 Cooper Point Rd SW
Olympia, WA 98502
Phone (360) 486-6710

1620 Cooper Point Rd SW
#303
Olympia, WA 98502

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

18313 Paulson St SW
Ste A
Rochester, WA 98579
Phone (360) 273-8818

Interoperability endpoints

  • Direct secure messaging: apatel665602@wm.providencedirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1235579756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 COOPER POINT RD SW",
            "address_2": "MA303, DC032.00",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025736",
            "telephone_number": "573-884-2912",
            "fax_number": "573-884-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N HOSPITAL DR",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652512511",
            "telephone_number": "573-642-5911",
            "fax_number": "573-642-3015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 Cooper Point Rd SW",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985025736",
            "country_code": "US",
            "telephone_number": "360-486-6710",
            "fax_number": "360-705-0269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ANDREW",
        "middle_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-28",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60658462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apatel665602@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1620 Cooper Point Rd SW",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985025736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fulton, MO

Sources for this page

Verify at the official NPI Registry.