Individual provider Active NPI

Andrew Nicholas Nemecek, MD

  • Neurological Surgery Physician
  • Vancouver, WA
National Provider Identifier
1467460923
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD00045323 Issued in WA
Practice address
200 NE Mother Joseph PL Ste 300
Vancouver, WA 98664
Phone
(360) 254-6161
Fax
(360) 449-1146
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD26582 OR
Neurological Surgery Physician 207T00000X MD00045323 WA Primary

Addresses

Primary practice location

200 NE Mother Joseph PL Ste 300
Vancouver, WA 98664

Mailing address

200 NE Mother Joseph PL Ste 210
Vancouver, WA 98664-3295
Phone (360) 254-6161

Other identifiers 2

IdentifierTypeStateIssuer
023811MedicaidOR
1467460923MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050906000528 WA Practitioner - Neurosurgery 3577595040 Reassigns benefits to 1 organization
I20051018000120 OR Practitioner - Neurosurgery 3577595040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Surgical Specialists PCGroup PAC ID 4183527153, 118 clinicians

Practice addresses (Care Compare)

1 N Ctr Court St
110 Rebound Sports Medicine
Portland, OR 97227-2104
Phone (503) 732-6863

200 NE Mother Joseph PL
300 Rebound Neurosurgery Brain and Spine
Vancouver, WA 98664-3296
Phone (360) 254-6161

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050
  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150
  • Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041
  • Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion47
Laminectomy or laminotomy (partial removal of spine bones)36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD26582ORMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Surgical Specialists PC CurrentSince Aug 1, 2012 Accepting new patients
Northwest Surgical Specialists, P.C. Neurological Surgery CurrentSince Aug 1, 2012 Accepting new patients
J and D Physical Therapy Services Past Accepting new patients

Locations

1 N Center Court St
Ste 110
Portland, OR 97227
Phone (503) 732-6863

1 N Center Court St
Ste 11
Portland, OR 97227
Phone (503) 732-6863

200 NE Mother Joseph Pl
Ste 210
Vancouver, WA 98664
Phone (360) 449-1145

2121 NE 139th St
Ste 300
Vancouver, WA 98686

200 NE Mother Joseph Pl
Ste 300
Vancouver, WA 98664
Phone (360) 256-4060

200 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2990

Interoperability endpoints

  • Direct secure messaging: andrew.nemecek.p1@direct.reboundmd.nextgenshare.com
  • Direct secure messaging: anemecek21711@reboundmd.gardenplot.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1467460923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643295",
            "telephone_number": "360-254-6161",
            "fax_number": "360-449-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98664",
            "telephone_number": "360-254-6161",
            "fax_number": "360-449-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMECEK",
        "first_name": "ANDREW",
        "middle_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OR",
            "license": "MD26582",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WA",
            "license": "MD00045323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023811",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467460923",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.