NPIMap

Individual provider Active NPI

Arnab Mitra, M.D.

  • Gastroenterology Physician
  • Portland, OR
National Provider Identifier
1003175464
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD176770 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd # L461
Oregon Health and Science University
Portland, OR 97239-3011
Phone
(503) 494-7127
NPI assigned
May 4, 2012
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Gastroenterology Physician 207RG0100X MD176770 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd # L461
Oregon Health and Science University
Portland, OR 97239-3011

Mailing address

Oregon Health and Science University, Gi Division
3181 SW Sam Jackson Park Road, L461
Portland, OR 97239-3098

Other practice location 1

3485 S Bond Ave
Portland, OR 97239-4503
Phone (503) 494-4373

Other practice location 2

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8500

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Northwest Permanente PC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190815000748 OR Practitioner - Internal Medicine 8527282797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Alabama School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy14
Upper gastrointestinal (GI) endoscopy for acid reflux14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD176770ORMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Aug 21, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 16, 2021 Accepting new patients
University Professional Services CurrentSince Aug 21, 2019 Accepting new patients
University Professional Services Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 16, 2021 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

9900 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-8240

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3181 SW Sam Jackson Park Rd
#L461
Portland, OR 97239
Phone (503) 494-2270

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

3600 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

Interoperability endpoints

  • Direct secure messaging: amitramd96727@direct.ohsu.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1003175464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "OREGON HEALTH AND SCIENCE UNIVERSITY, GI DIVISION",
            "address_2": "3181 SW SAM JACKSON PARK ROAD, L461",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # L461",
            "address_2": "OREGON HEALTH AND SCIENCE UNIVERSITY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3485 S Bond Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972394503",
            "country_code": "US",
            "telephone_number": "503-494-4373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITRA",
        "first_name": "ARNAB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-04",
        "last_updated": "2022-02-04",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "MD176770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Northwest Permanente PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9900 SE Sunnyside Rd",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970159777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.