Individual provider Active NPI

Andrew Sheppert, MD

  • Otolaryngology Physician
  • Vancouver, WA
National Provider Identifier
1558309690
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD00043330 Issued in WA
Practice address
700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone
(360) 397-1500
Fax
(360) 397-3128
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD00043330 WA Primary

Addresses

Primary practice location

700 NE 87TH Ave
Vancouver, WA 98664-1913

Mailing address

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 397-1500

Other identifiers 1

IdentifierTypeStateIssuer
8400277MedicaidWA

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
I20040809000524 WA Practitioner - Otolaryngology 0446222608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Wake Forest University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

2621 NE 134TH St
Suite 300
Vancouver, WA 98686-3036
Phone (360) 882-2778

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00043330WAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: asheppert2286@tvc-direct.org

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199059200000",
    "number": "1558309690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-397-1500",
            "fax_number": "360-397-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-397-1500",
            "fax_number": "360-397-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPERT",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00043330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8400277",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.