NPIMap

Individual provider Active NPI

Humza Saleem Maqbool, MD

  • Internal Medicine Physician
  • Seaside, OR
National Provider Identifier
1003334368
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD196981 Issued in OR
Practice address
725 S Wahanna Rd
Seaside, OR 97138-7735
Phone
(503) 717-7000
NPI assigned
Sep 6, 2017
Last updated
Feb 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT212992 PA
Internal Medicine Physician 207R00000X MD196981 OR Primary

Addresses

Primary practice location

725 S Wahanna Rd
Seaside, OR 97138-7735

Mailing address

PO Box 3397
Portland, OR 97208-3397

Other practice location 1

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 534-9104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200728001169 OR Practitioner - Internal Medicine 0244654986 Reassigns benefits to 2 organizations
I20240425001132 VA Practitioner - Internal MedicinePractitioner - Hospitalist 0244654986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of VA LLCGroup PAC ID 5991160160, 19 clinicians

Practice addresses (Care Compare)

4600 Spotsylvania Pkwy
Fredericksburg, VA 22408-7762
Phone (540) 498-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD196981ORMDInternal Medicine Physician
MT212992PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of VA, LLC CurrentSince Feb 12, 2024 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Internal Medicine Current Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince May 12, 2021 Accepting new patients

Locations

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

9205 SW Barnes Rd
Fl 1
Portland, OR 97225
Phone (503) 216-0790

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

4600 Spotsylvania Pkwy
Fredericksburg, VA 22408
Phone (540) 498-4000

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 4

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": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1003334368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3397",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S WAHANNA RD",
            "city": "SEASIDE",
            "state": "OR",
            "postal_code": "971387735",
            "telephone_number": "503-717-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1086 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Johnstown",
            "state": "PA",
            "postal_code": "159054305",
            "country_code": "US",
            "telephone_number": "814-534-9104",
            "fax_number": "814-534-9104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAQBOOL",
        "first_name": "HUMZA",
        "middle_name": "SALEEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-06",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT212992",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD196981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaside, OR

Sources for this page

Verify at the official NPI Registry.