Brad L Andersen, MD
Individual provider Active NPI Family Medicine Physician · Poulsbo, WA
NPI 1598831406 · NPPES record last updated May 23, 2011
Key facts
- NPI
- 1598831406
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD00034121 (WA)
- Practice address
- 22180 Olympic College Way
Suite 201
Poulsbo, WA 98370-6664 - Phone
- (360) 394-3500
- Fax
- (360) 394-3501
- NPI assigned
- Nov 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Washington School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Sound Family Medicine and Urgent Care PLLC
Practice addresses (Care Compare)
22180 Olympic College Way NW
Suite 201
Poulsbo, WA 98370-6664
Phone (360) 394-3500
Hospital & facility affiliations
- Centerwell Home Health
- Aleca Home Health
- St Michael Medical Center
- Jefferson Healthcare
- Olympic Medical Center
- St Joseph Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 30 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040510000834 | WA | Practitioner - Family Practice | 6002805561 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Family Medicine and Urgent Care PLLC | Current |
Accepting new patients | |
| SFH Diagnostics LLC | Past |
Accepting new patients | |
| Peninsula Community Health Services | Family Medicine | Past | Accepting new patients |
| North Kitsap Family Practice and Urgent Care P.S. | Family Medicine | Past | Accepting new patients |
| Peninsula Community Health Services | Past | Accepting new patients |
Locations
22180 Olympic College Way NW
Ste 201
Poulsbo, WA 98370
Phone (360) 394-3500
Interoperability endpoints
- brad.andersen.1@24533.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00034121 | WA | Yes |
Addresses
Primary practice location
22180 Olympic College Way
Suite 201
Poulsbo, WA 98370-6664
Mailing address
22180 Olympic College Way
Suite 201
Poulsbo, WA 98370-6664
Phone (360) 394-3500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P000366802 | Other | WA | RAILROAD MEDICARE |
| 8247181 | Medicaid | WA |
Other providers in Poulsbo, WA
- Darcy M Allbee
- Sarah S Allbee
- Kerry Allen
- Abdullah Alsamman
- Amfm Healthcare Washington
- Teresa A Andersen
- Anderson Denture Center, Inc.
- Bradley Troy Anderson
- Christopher C.M. Anderson
- Marlaina Anderson
All providers in Poulsbo, WA · Family Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.