Andreas Hennig

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

TL.0005906 Issued in CO

Practice address

783 NW Naito Pkwy Apt 502
Portland, OR 97209-4755

Phone

(619) 733-4150

NPI assigned

Apr 27, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

General Surgery

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006
• St Luke's Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  Surgery

  Medicare reassignment Care Compare group NPD
• Deaconess Memorial Medical Center Inc

  dba Memorial Healthcare of Huntingburg

  • Emergency Medicine Physician
  • Huntingburg, IN
  • NPI 1114120128
  NPD
• Deaconess Memorial Medical Center Inc

  dba Deaconess Comprehensive Pain Management - Jasper

  • Pain Medicine Physician
  • Jasper, IN
  • NPI 1457164543
  NPD
• Deaconess Memorial Medical Center Inc

  dba Memorial Surgical Associates

  • Surgery Physician
  • Jasper, IN
  • NPI 1912579574
  NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• St Lukes West LTD

  dba St Lukes Nampa Medical Center

  • General Acute Care Hospital
  • Nampa, ID
  • NPI 1831590660
  Care Compare affiliation

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1366897399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "783 NW NAITO PKWY APT 502",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972094755",
            "telephone_number": "619-733-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "783 NW NAITO PKWY APT 502",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972094755",
            "telephone_number": "619-733-4150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 S Eagle Rd Ste 1241",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836426355",
            "country_code": "US",
            "telephone_number": "208-381-6930",
            "fax_number": "208-381-6931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNIG",
        "first_name": "ANDREAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "TL.0005906",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "O-1983",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Henn
• Stacy Lynn Henne, MS
• Eleanor Hennen
• Catherine Hennessy, L.C.S.W.
• Mary Catherine Hennessy, LPC
• Bridgette Hennigsen
• Andrew Munson Henning, APRN
• Catherine Chau Henning, APRN
• Amy Katherine Henninger, MD
• Lexy Frances Henninger

• Surgery Physician in Portland, OR
• Providers in Portland, OR by specialty
• Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.