Beth A. Andersen, MD – Pediatric Urology Physician

Key facts

NPI: 1750465472
Entity type: Individual (NPI type 1)
Primary specialty: Pediatric Urology Physician 2088P0231X
License: MD223301 (OR)
Practice address: 2100 Clinch Ave Ste 120
Knoxville, TN 37916-2288
Phone: (865) 637-7290
NPI assigned: Oct 25, 2006
Sex: Female
Sole proprietor: No

Organizations & group practices 9

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.

Legacy Emanuel Hospital & Health Center General Acute Care Hospital · Portland, OR · NPI 1831112358

Medicare reassignment NPD OR
Multicare Health System Neurological Surgery Physician · Tacoma, WA · NPI 1497766638

Medicare reassignment NPD WA
St Lukes Clinic-Treasure Valley LLC Family Medicine Physician · Boise, ID · NPI 1326336058

Medicare reassignment NPD ID · UROLOGY
Legacy Emanuel Hospital & Health Center Community/Retail Pharmacy · Portland, OR · NPI 1417977976

NPD
Legacy Emanuel Hospital & Health Center Clinic/Center · Portland, OR · NPI 1700809027

NPD
Multicare Health System Community/Retail Pharmacy · Spokane, WA · NPI 1396594875

NPD
St Lukes Clinic-Treasure Valley LLC Family Medicine Physician · Mountain Home, ID · NPI 1417297821

NPD
University Pediatric Urology, PC Specialist · Knoxville, TN · NPI 1396779039

NPD (past)
Multicare Health System Family Medicine Physician · Auburn, WA · NPI 1013969195

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled (3 enrollments) in WA, OR, ID
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
I20120124000411	WA	Practitioner - Pediatric Medicine Practitioner - Urology	0840467387	Reassigns benefits to 1 organization
I20250117002452	OR	Practitioner - Pediatric Medicine	0840467387	Reassigns benefits to 1 organization
I20250423003765	ID	Practitioner - Urology	0840467387	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
G186314	CA	MD	Urology Physician
MD223301	OR	MD	Pediatric Urology Physician
WA00034550	WA	MD	Pediatric Urology Physician

Practice roles

Organization	Specialty	Status	New patients
St Lukes Clinic-Treasure Valley LLC		Current since Jan 25, 2025	Accepting new patients
Multicare Health System		Current since Oct 1, 2025	Accepting new patients
St Lukes Clinic-Treasure Valley LLC	Urology	Current since Jan 25, 2025	Accepting new patients
Legacy Emanuel Hospital & Health Center		Current since Jan 15, 2025	Accepting new patients
Multicare Health System		Current since Oct 1, 2025	Accepting new patients
Legacy Emanuel Hospital & Health Center		Current	Accepting new patients
Legacy Emanuel Hospital & Health Center		Current since Jan 15, 2025	Accepting new patients
University Pediatric Urology, PC		Past	Accepting new patients
Multicare Health System		Past	Accepting new patients

Locations

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

305 E Jefferson St
Boise, ID 83712
Phone (208) 345-0715

501 N Graham St
Ste 300
Portland, OR 97227
Phone (503) 413-4300

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

501 N Graham St
Ste 200
Portland, OR 97227
Phone (503) 413-4488

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

17700 SE 272nd St
#460
Kent, WA 98042

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

1101 Madison St
Ste 800
Seattle, WA 98104

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

Interoperability endpoints

Direct secure messaging: bandersen1041010@wm.providencedirect.org

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pediatric Urology Physician	2088P0231X	WA00034550	WA
Pediatric Urology Physician	2088P0231X	5961565	ID
Pediatric Urology Physician	2088P0231X	MD223301	OR	Yes
Urology Physician	208800000X	G186314	CA
Urology Physician	208800000X	MD00034550	WA

Addresses

Primary practice location

2100 Clinch Ave Ste 120
Knoxville, TN 37916-2288

Mailing address

2219 Broadway E
Seattle, WA 98102-4135
Phone (206) 499-9585

Other practice location 1

1101 Madison St Ste 800
Seattle, WA 98104-1307
Phone (206) 215-2700

Other practice location 2

3716 Standridge Dr
The Colony, TX 75056-4566
Phone (469) 249-9000

Other practice location 3

9300 Valley Childrens Pl # Sc05
Madera, CA 93636-8761
Phone (559) 353-5700

Other practice location 4

305 E Jefferson St
Boise, ID 83712-6231
Phone (208) 381-6196

Other practice location 5

501 N Graham St Ste 300
Portland, OR 97227-2008
Phone (503) 413-4300

Electronic endpoints

Type	Endpoint	Use	Affiliation
Direct Messaging Address	bandersen1041010@wm.providencedirect.org	Direct

Other providers in Knoxville, TN

All providers in Knoxville, TN · Pediatric Urology Physician in Tennessee

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2025. 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).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.