Individual provider Active NPI

Patricio A. Riquelme, M.D., PH.D.

  • Hospitalist Physician
  • Portland, OR
National Provider Identifier
1023317492
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD167475 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Bte119
Portland, OR 97239-3011
Phone
(503) 494-1164
Fax
(503) 494-1159
NPI assigned
Mar 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A122559 CA
Internal Medicine Physician 207R00000X MD167475 OR
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X MD167475 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Bte119
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Bte119
Portland, OR 97239-3011
Phone (503) 494-1164

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140616002236 OR Practitioner - HospitalistPractitioner - Internal Medicine 2961626866 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portland Adventist Medical CenterGroup PAC ID 3274908819, 273 clinicians
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

10123 SE Market St
Portland, OR 97216-2532
Phone (503) 257-2500

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A122559CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jul 15, 2014 Accepting new patients
Tuality Medical Group LLC Internal Medicine CurrentSince Jun 1, 2018 Accepting new patients
Tuality Healthcare CurrentSince Jun 1, 2018 Accepting new patients
Portland Adventist Medical Center CurrentSince Sep 1, 2023 Accepting new patients
Tuality Healthcare CurrentSince Jun 1, 2018 Accepting new patients
University Professional Services CurrentSince Jul 15, 2014 Accepting new patients
Tuality Medical Group LLC CurrentSince Jun 1, 2018 Accepting new patients
Portland Adventist Medical Center Internal Medicine CurrentSince Sep 1, 2023 Accepting new patients
Tuality Healthcare Current Accepting new patients

Locations

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

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

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

10123 SE Market St
Portland, OR 97216
Phone (503) 251-6355

3181 SW Sam Jackson Park Rd
#119
Portland, OR 97239
Phone (503) 494-1164

Interoperability endpoints

  • Direct secure messaging: priquelme87349@direct.ohsu.edu

Organizations & group practices 9

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 2

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": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1023317492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "BTE119",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-1164",
            "fax_number": "503-494-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "BTE119",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-1164",
            "fax_number": "503-494-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIQUELME",
        "first_name": "PATRICIO",
        "middle_name": "A.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-24",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A122559",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD167475",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD167475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.