Active NPI
Carolyn Coghill Piszczek, M.D.
- Obstetrics & Gynecology Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD171024
- Practice address
- 1050 NW 22ND Avenue, Northup BLDG.,
Suite 23
Portland, OR 97210 - Phone
- (503) 413-7529
- NPI assigned
- Jan 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | 24857 | NE | |
| Obstetrics & Gynecology Physician | 207V00000X | 133637 | CA | |
| Obstetrics & Gynecology Physician | 207V00000X | MD171024 | OR | Primary |
Addresses
Primary practice location
1050 NW 22ND Avenue, Northup BLDG.,
Suite 23
Portland, OR 97210
Mailing address
1050 NW 22ND Ave
Northup BLDG, Suite 23
Portland, OR 97210
Phone (503) 413-7529
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 133637 | CA | MD | Obstetrics & Gynecology Physician |
| 24857 | NE | MD | Obstetrics & Gynecology Physician |
| MD171024 | OR | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Obstetrics & Gynecology | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Obstetrics & Gynecology | Current | Accepting new patients |
Locations
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
3550 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Organizations & group practices 3
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Obstetrics & Gynecology, WA
-
- General Practice Physician
- Portland, OR
- NPI 1871848457
Obstetrics & Gynecology
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1023161262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 NW 22ND AVE",
"address_2": "NORTHUP BLDG, SUITE 23",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97210",
"telephone_number": "503-413-7529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 NW 22ND AVENUE, NORTHUP BLDG.,",
"address_2": "SUITE 23",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97210",
"telephone_number": "503-413-7529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PISZCZEK",
"first_name": "CAROLYN",
"middle_name": "COGHILL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-19",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NE",
"license": "24857",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "133637",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OR",
"license": "MD171024",
"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": "3550 N Interstate Ave",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972271196",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.