Rebecca Shannon Andahazy, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA61581825 Issued in WA

Practice address

18012 68TH Ave S Ste 101
Kent, WA 98032-1022

Phone

(425) 291-3300

Fax

(425) 291-5300

NPI assigned

Dec 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Rebecca Shannon Smith Former name

Medicare fee-for-service enrollment

Enrolled in AL, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rssmith@direct.uabmedicine.org

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.

• King County Public Hospital District No 2

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment Care Compare group
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• Pacific Northwest Medical Services PLLC

  • Urgent Care Clinic/Center
  • Kent, WA
  • NPI 1902188196
  Medicare reassignment
• American Family Care, LLC

  • Primary Care Clinic/Center
  • Birmingham, AL
  • NPI 1669429080
  Medicare reassignment
• King County Public Hospital District No 2

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1902907165
  NPD
• King County Public Hospital District No. 2

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• King County Public Hospital District No. 2

  • Clinic/Center
  • Redmond, WA
  • NPI 1750612883
  NPD
• American Family Care, LLC

  • Family Medicine Physician
  • Vestavia Hills, AL
  • NPI 1265210645
  NPD
• University of Alabama Health Services Foundation, PC

  • Clinical Medical Laboratory
  • Birmingham, AL
  • NPI 1164617205
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• King County Public Hospital District No. 2

  • General Acute Care Hospital
  • Kirkland, WA
  • NPI 1033174933
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1700424959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6116",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980646116",
            "telephone_number": "425-291-3300",
            "fax_number": "425-291-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18012 68TH AVE S STE 101",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980321022",
            "telephone_number": "425-291-3300",
            "fax_number": "425-291-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDAHAZY",
        "first_name": "REBECCA",
        "middle_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61581825",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02567",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.1551",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "PA61581825",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "SMITH",
            "middle_name": "SHANNON",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amdg Ventures, Inc.
• American Current Care of Washington, P.S.
• Aszurea Amy
• Wendy Wan Anan, MD
• Melissa Ancelin
• Aaron Anderberg
• Kelsee Andersen Mellor, OT
• Kevin Andersen, D.C.
• George C Anderson, PT
• Jens Martin Anderson, DDS

• Medical Physician Assistant in Kent, WA
• Providers in Kent, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.