Individual provider Active NPI

Megumi S Ketcham, M.D.

  • Emergency Medicine Physician
  • Vancouver, WA
National Provider Identifier
1023370293
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD60555328 Issued in WA
Practice address
2211 NE 139TH St
Vancouver, WA 98686-2742
Phone
(360) 487-1000
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD60555328 WA Primary

Addresses

Primary practice location

2211 NE 139TH St
Vancouver, WA 98686-2742

Mailing address

PO Box 4979
Portland, OR 97208-4979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150924001185 WA Practitioner - Emergency Medicine 9638487648 Reassigns benefits to 1 organization
I20200409000519 OR Practitioner - Emergency Medicine 9638487648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.85 of 100Reported as group
Quality
84.92
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Acute Care Specialists PC Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Northwest Acute Care Specialists PC Emergency Medicine CurrentSince Nov 1, 2015 Accepting new patients

Locations

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1023370293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4979",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 NE 139TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862742",
            "telephone_number": "360-487-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHAM",
        "first_name": "MEGUMI",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60555328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.