Andrea Johansen

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61590871 Issued in WA

Practice address

20618 142ND Ave SE
Kent, WA 98042-3066

Phone

(415) 891-5110

NPI assigned

Jun 26, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Dispatchhealth Washington PCGroup PAC ID 2062765423, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrea.johansen.1@13869.direct.athenahealth.com
• Direct secure messaging: andrea.johansen.1@30646.direct.athenahealth.com

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.

• Dispatchhealth Washington PC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1013490507
  Medicare reassignment Care Compare group NPD
• Peacehealth Networks on Demand, LLC

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178

  WA

  Medicare reassignment Care Compare group NPD
• Dispatchhealth Advanced Care - Washington PC

  • Hospitalist Physician
  • Denver, CO
  • NPI 1093324659
  NPD

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723852800000",
    "number": "1720764731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20618 142ND AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980423066",
            "telephone_number": "415-891-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20618 142ND AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980423066",
            "telephone_number": "415-891-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2024-08-17",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61590871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rena Jhuty, D.M.D
• Stacy Jillson
• Charlie N Jim, LMT
• Lee Ann T Jinguji, DDS
• Thomas M Jinguji
• Persephone Johansson
• John Beack DMD PS
• John Cheng
• Kenneth George Johnsen, DDS
• Adam-Omar Johnson

• Family Nurse Practitioner in Kent, WA
• Providers in Kent, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.