Individual provider Active NPI

Andrew J Haputa, M.D.

  • Surgery Physician
  • Sisseton, SD
National Provider Identifier
1700855491
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD0044349 Issued in WA
Practice address
205 Orchard Dr
Sisseton, SD 57262-2398
Phone
(605) 698-7681
Fax
(605) 698-6423
NPI assigned
Mar 15, 2006
Last updated
May 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD0044349 WA Primary

Addresses

Primary practice location

205 Orchard Dr
Sisseton, SD 57262-2398

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

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
I20050809000884 WA Practitioner - General Surgery 7911936026 Reassigns benefits to 1 organization
I20181213000575 OR Practitioner - General Surgery 7911936026 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0044349WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jul 1, 2005 Accepting new patients
Good Shepherd Health Care System CurrentSince Oct 1, 2018 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Jul 1, 2005 Accepting new patients
Coteau Des Prairies Hospital,Inc Past Accepting new patients

Locations

610 NW 11th St
Hermiston, OR 97838
Phone (541) 667-3400

16122 8th Ave SW
Ste D1
Burien, WA 98166
Phone (206) 241-7146

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1700855491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ORCHARD DR",
            "city": "SISSETON",
            "state": "SD",
            "postal_code": "572622398",
            "telephone_number": "605-698-7681",
            "fax_number": "605-698-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAPUTA",
        "first_name": "ANDREW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD0044349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sisseton, SD

Sources for this page

Verify at the official NPI Registry.