Individual provider Active NPI

Aurora Horstkamp, MD

  • Family Medicine Physician
  • Pullman, WA
National Provider Identifier
1255304499
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00033290 Issued in WA
Practice address
NE 1125 Washington St
Washington State University
Pullman, WA 99164-0001
Phone
(509) 335-3575
NPI assigned
Feb 8, 2006
Last updated
Jun 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00033290 WA Primary
Family Medicine Physician 207Q00000X M-16585 ID

Addresses

Primary practice location

NE 1125 Washington St
Washington State University
Pullman, WA 99164-0001

Mailing address

PO Box 367
Lapwai, ID 83540-0367

Other practice location 1

11 Bever Grade Rd
Lapwai, ID 83540-0367
Phone (208) 843-2271

Other identifiers 1

IdentifierTypeStateIssuer
8436826MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220131000545 TX Practitioner - Family Practice 7315998473 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-16585IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nez Perce Tribal Health Authority CurrentSince Feb 22, 2022 Accepting new patients
Evergreen Family Medicine, PC Family Medicine Past Accepting new patients

Locations

313 3Rd St
Nimiipuu Health
Kamiah, ID 83536
Phone (208) 621-4946

Interoperability endpoints

  • Direct secure messaging: aurorah@nimiipuuhealth.directbygreenway.com
  • FHIR API: https://api.platform.athenahealth.com/1334/brand/1/csg/42/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1255304499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "LAPWAI",
            "state": "ID",
            "postal_code": "835400367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NE 1125 WASHINGTON ST",
            "address_2": "WASHINGTON STATE UNIVERSITY",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991640001",
            "telephone_number": "509-335-3575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Bever Grade Rd",
            "address_purpose": "LOCATION",
            "city": "Lapwai",
            "state": "ID",
            "postal_code": "835400367",
            "country_code": "US",
            "telephone_number": "208-843-2271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORSTKAMP",
        "first_name": "AURORA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00033290",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-16585",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8436826",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

Verify at the official NPI Registry.