Individual provider Active NPI

Nicholas Ryan Sandersfeld, D.O.

  • Psychiatry Physician
  • Spokane, WA
National Provider Identifier
1376804708
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OP60608490 Issued in WA
Practice address
105 W 8TH Ave
Suite 450E
Spokane, WA 99204-2302
Phone
(509) 474-6920
NPI assigned
Jun 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5101020604 MI
Student in an Organized Health Care Education/Training Program 390200000X 9407902 KS
Psychiatry Physician 2084P0800X OP60608490 WA Primary

Addresses

Primary practice location

105 W 8TH Ave
Suite 450E
Spokane, WA 99204-2302

Mailing address

PO Box 421
Michigan State University, Dept Psychiatry
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

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
I20160719001675 WA Practitioner - Psychiatry 1153543129 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP60608490WAMDPsychiatry Physician
9407902KSMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jun 2, 2023 Accepting new patients
Washington Pac Services PC CurrentSince Oct 1, 2020 Accepting new patients
CS Pacs 3 Northwest, LLC CurrentSince Sep 28, 2024 Accepting new patients
Multicare Health System CurrentSince Jun 2, 2023 Accepting new patients
Wa Pacs 2 PC CurrentSince Oct 1, 2020 Accepting new patients

Locations

21008 76th Ave W
Edmonds, WA 98026
Phone (425) 778-0107

135 S 336th St
Federal Way, WA 98003
Phone (253) 835-7433

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

920 12th Ave SE
Puyallup, WA 98372
Phone (253) 841-3422

3600 E Hartson Ave
Spokane, WA 99202
Phone (509) 468-7000

14820 E 4th Ave
Spokane Valley, WA 99216
Phone (509) 922-1644

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1376804708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "address_2": "MICHIGAN STATE UNIVERSITY, DEPT PSYCHIATRY",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 8TH AVE",
            "address_2": "SUITE 450E",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042302",
            "telephone_number": "509-474-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSFELD",
        "first_name": "NICHOLAS",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-01",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101020604",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KS",
            "license": "9407902",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "OP60608490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.