Individual provider Active NPI

Emmanuel Trungtoan Tavan, MD

  • Pulmonary Disease Physician
  • Portland, OR
National Provider Identifier
1003007907
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD160052 Issued in OR
Practice address
2800 N Vancouver Ave
Suite 230
Portland, OR 97227-1630
Phone
(503) 413-2901
NPI assigned
Aug 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD160052 OR Primary

Addresses

Primary practice location

2800 N Vancouver Ave
Suite 230
Portland, OR 97227-1630

Mailing address

6223 SE Grant St
Portland, OR 97215-4058
Phone (503) 774-6308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130820000325 OR Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 8224283056 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Oregon Health Sciences University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Good Samaritan Hospital and Medical CenterGroup PAC ID 0547179939, 190 clinicians
Legacy Meridian Park HospitalGroup PAC ID 5092609842, 113 clinicians
Legacy Mount Hood Medical CenterGroup PAC ID 3173515996, 58 clinicians
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians
Silverton HealthGroup PAC ID 8921901877, 147 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711

1130 NW 22ND Ave
Suite 400
Portland, OR 97210-2971
Phone (503) 413-6722

19300 SW 65TH Ave
Tualatin, OR 97062-7706
Phone (503) 413-4330

24800 SE Stark St
Gresham, OR 97030-3378
Phone (503) 661-9150

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200

342 Fairview St
Silverton, OR 97381-1917
Phone (503) 525-7660

Hospital & facility affiliations

  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD160052ORMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Aug 1, 2013 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Feb 10, 2014 Accepting new patients
Silverton Health CurrentSince Dec 15, 2019 Accepting new patients
Silverton Health Current Accepting new patients
Legacy Mount Hood Medical Center Current Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Dec 7, 2013 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Feb 10, 2014 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Dec 7, 2013 Accepting new patients
Silverton Health CurrentSince Dec 15, 2019 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Dec 7, 2013 Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Apr 22, 2014 Accepting new patients
Legacy Meridian Park Hospital Past Accepting new patients

Locations

25050 SE Stark St
Gresham, OR 97030
Phone (503) 413-5702

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

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

1040 NW 22nd Ave
Ste 168
Portland, OR 97210
Phone (503) 413-7022

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1130 NW 22nd Ave
Ste 400
Portland, OR 97210
Phone (503) 413-6555

2800 N Vancouver Ave
Ste 230
Portland, OR 97227
Phone (503) 413-2901

2222 NW Lovejoy St
Ste 411
Portland, OR 97210
Phone (503) 413-5702

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Organizations & group practices 12

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 9

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1003007907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6223 SE GRANT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972154058",
            "telephone_number": "503-774-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N VANCOUVER AVE",
            "address_2": "SUITE 230",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271630",
            "telephone_number": "503-413-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAN",
        "first_name": "EMMANUEL",
        "middle_name": "TRUNGTOAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD160052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.