NPIMap

Individual provider Active NPI

Nicholas Hasandras, D.O.

  • Internal Medicine Physician
  • Mount Vernon, WA
National Provider Identifier
1467808428
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
78149 Issued in MT
Practice address
1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone
(360) 814-2115
NPI assigned
May 9, 2016
Last updated
Nov 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 78149 MT Primary

Addresses

Primary practice location

1415 E Kincaid St
Mount Vernon, WA 98274-4126

Mailing address

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 814-2115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191119002326 MT Practitioner - Internal Medicine 8022301084 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of Montana P CGroup PAC ID 4486712833, 82 clinicians

Practice addresses (Care Compare)

2827 Fort Missoula Rd
Missoula, MT 59804-7408
Phone (406) 728-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78149MTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Montana P C Internal Medicine CurrentSince Sep 21, 2019 Accepting new patients
RCHP Billings - Missoula LLC Current Accepting new patients
Hospitalist Medicine Physicians of Montana - TCS PC Internal Medicine CurrentSince Feb 12, 2022 Accepting new patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients

Locations

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Interoperability endpoints

  • Direct secure messaging: nhasandras@direct.communitymed.org

Organizations & group practices 4

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.

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": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1467808428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744126",
            "telephone_number": "360-814-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744126",
            "telephone_number": "360-814-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASANDRAS",
        "first_name": "NICHOLAS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "78149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.