ANDREA JOHANSEN
NPI 1720764731
Nurse Practitioner - Family in Kent, WA

Active since June 26, 2023PECOS EnrolledAccepts Medicare Assignment
20618 142ND AVE SE, KENT, WA 98042(415) 891-5110 Get Directions Write a Review

NPPES record last updated: August 17, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Andrea Johansen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREA JOHANSEN (NPI 1720764731) is an individual family provider in Kent, Washington, licensed in Washington (AP61590871) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1720764731
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameANDREA JOHANSEN
Location Address20618 142ND AVE SEKent, WA 98042-3066
Mailing Address20618 142nd Ave SeKent, WA 98042-3066 · (415) 891-5110
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJune 26, 2023
Last NPPES UpdateAugust 17, 2024
NPPES CertifiedAugust 17, 2024
NPI 1720764731 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in WA · AP61590871
20618 142ND AVE SE, Kent, WA 98042

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Andrea Johansen is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921549080
PECOS Enrollment IDI20240917003430
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98042 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$97.43 typical visit price
range $63.67 – $189.37
Typical copayment $24.35 (range $15.91 – $47.34)
Most-billed visit code 99203
Established Patient
$111.00 typical visit price
range $21.12 – $155.00
Typical copayment $27.75 (range $5.28 – $38.75)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720764731, enumerated as an "individual" on June 26, 2023.

The provider is located at 20618 142ND AVE SE KENT, WA 98042 and the phone number is (415) 891-5110.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

The provider might be accepting Accepts: Providence Health Plan. Please consult your insurance carrier or call the provider to verify.