Sanjiv M Panwala, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00032898 Issued in WA

Practice address

9205 SW Barnes Rd FL 1
Portland, OR 97225-6603

Phone

(503) 216-2906

Fax

(503) 216-4114

NPI assigned

Jul 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  Internal Medicine

  Medicare reassignment NPD
• Silverton Health

  • General Acute Care Hospital
  • Silverton, OR
  • NPI 1669424354
  Medicare reassignment NPD
• CRM Physicians, LLC

  • Internal Medicine Physician
  • Beaverton, OR
  • NPI 1952674996
  Medicare reassignment
• Legacy Clinics LLC

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  NPD
• Silverton Health

  • Specialist
  • Silverton, OR
  • NPI 1093828006
  NPD
• Silverton Health

  • Clinic/Center
  • Molalla, OR
  • NPI 1861116055
  NPD

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1023047321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2077",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082077",
            "telephone_number": "503-413-3900",
            "fax_number": "503-413-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD FL 1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256603",
            "telephone_number": "503-216-2906",
            "fax_number": "503-216-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANWALA",
        "first_name": "SANJIV",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00032898",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD22303",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00443367",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288194",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita Panoscha, MD
• Frances Irene Pansini, BSW
• George Alexander Pantely, MD
• Annalise Marie Panthofer, MD
• Johanna Mae Pantig
• Joseph Paul Panza, MA, LPC, CADC II
• Rajiv Ramchandra Paonaskar, D.D.S.
• Joel N Papak, M.D.
• Andrew Morgan Papazian, APRN, CRNA
• Charity Grace Pape, RN

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.