Individual provider Active NPI

Samantha Victoria D'Andrea, PA

  • Surgical Physician Assistant
  • Seattle, WA
National Provider Identifier
1740777275
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60840322 Issued in WA
Practice address
550 17TH Ave Ste 540
Seattle, WA 98122-4470
Phone
(206) 386-3880
Fax
(206) 386-3882
NPI assigned
Apr 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA60840322 WA Primary

Addresses

Primary practice location

550 17TH Ave Ste 540
Seattle, WA 98122-4470

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
1740777275MedicaidWA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180615001410 WA Practitioner - Physician Assistant 5799030730 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

500 17TH Ave
Seattle, WA 98122-5711
Phone (206) 320-2000

550 17TH Ave
Seattle, WA 98122-5789

747 Broadway
Seattle, WA 98122-4379
Phone (206) 386-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.1 of 100Reported as group
Quality
84.53
Promoting interoperability
100
Improvement activities
40
Cost
72.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60840322WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 CurrentSince Jun 6, 2018 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Jun 6, 2018 Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

12039 NE 128th St
Ste 500
Kirkland, WA 98034
Phone (425) 899-1220

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1740777275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 17TH AVE STE 540",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224470",
            "telephone_number": "206-386-3880",
            "fax_number": "206-386-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANDREA",
        "first_name": "SAMANTHA",
        "middle_name": "VICTORIA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-19",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60840322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740777275",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.