Active NPI
Andrea Legge, M.D.
- Family Medicine Physician
- Poulsbo, WA
National Provider Identifier
1871543900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00041542
- Practice address
- 19036 Front St NE Ste 100
Poulsbo, WA 98370-7354 - Phone
- (360) 979-0569
- Fax
- (877) 805-9505
- NPI assigned
- May 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00041542 | WA | Primary |
Addresses
Primary practice location
19036 Front St NE Ste 100
Poulsbo, WA 98370-7354
Mailing address
PO Box 2940
Poulsbo, WA 98370-2940
Phone (360) 979-0569
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8356883 | Medicaid | WA | |
| 8918CH | Other | REGENCE BLUESHIELD | |
| 172269 | Other | WA | LABOR & INDUSTRIES |
| P00045628 | Other | RAILROAD MEDICARE | |
| 7146476 | Other | AETNA |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Tulane University School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
19036 Front St NE
Suite 100
Poulsbo, WA 98370-7354
Phone (360) 979-0569
Hospital & facility affiliations
- St Michael Medical Center
- Jefferson Healthcare
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacifica Medicine | Family Medicine | Current | Accepting new patients |
| Chymiymattymd LLC | Family Medicine | Current | Accepting new patients |
Locations
19980 10th Ave NE
Ste 202
Poulsbo, WA 98370
Phone (360) 979-0569
19036 Front St NE
Ste 100
Poulsbo, WA 98370
Phone (360) 979-0569
19036 Front St NE
#100
Poulsbo, WA 98370
Phone (360) 979-0569
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
- achymiy@pmaw-wa.direct.office.nextgen.com
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Poulsbo, WA
- NPI 1982073235
-
- Family Medicine Physician
- Poulsbo, WA
- NPI 1831563600
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Silverdale, WA
- NPI 1518912609
-
- Medicare Defined Swing Bed Hospital Unit
- Port Townsend, WA
- NPI 1104950039
-
- Critical Access Hospital
- Port Townsend, WA
- NPI 1356492953
-
- Sleep Medicine (Psychiatry & Neurology) Physician
- Silverdale, WA
- NPI 1467664631
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1871543900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2940",
"city": "POULSBO",
"state": "WA",
"postal_code": "983702940",
"telephone_number": "360-979-0569",
"fax_number": "360-930-8213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19036 FRONT ST NE STE 100",
"city": "POULSBO",
"state": "WA",
"postal_code": "983707354",
"telephone_number": "360-979-0569",
"fax_number": "877-805-9505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGGE",
"first_name": "ANDREA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-11",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00041542",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8356883",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUESHIELD",
"identifier": "8918CH",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "172269",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00045628",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7146476",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Poulsbo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.