Active NPI
Andre C Joseph Jr., MD
- Surgery Physician
- Seattle, WA
National Provider Identifier
1396816005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD00028422
- Practice address
- 201 16TH Ave E
Seattle, WA 98112-5226 - Phone
- (206) 326-3000
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD00028422 | WA | Primary |
Addresses
Primary practice location
201 16TH Ave E
Seattle, WA 98112-5226
Mailing address
201 16TH Ave E
Seattle, WA 98112-5226
Phone (206) 326-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1103969 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kingman Healthcare, Inc | Family Medicine | Current | Accepting new patients |
| Kingman Healthcare, Inc | Family Medicine | Past | Accepting new patients |
Locations
3104 N Stockton Hill Rd
Kingman, AZ 86401
Phone (928) 681-8720
3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626
Interoperability endpoints
- joseph.andre@st.direct.azkrmc.md
- joseph.andre@direct.azkrmc.md
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619049600000",
"number": "1396816005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 16TH AVE E",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981125226",
"telephone_number": "206-326-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 16TH AVE E",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981125226",
"telephone_number": "206-326-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "ANDRE",
"middle_name": "C",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2021-04-22",
"certification_date": "2021-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "MD00028422",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1103969",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "201 16th Ave E",
"city": "Seattle",
"state": "WA",
"country_code": "US",
"postal_code": "981125226",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.