NPIMap

Individual provider Active NPI

Merin Jose

  • Internal Medicine Physician
  • Beaverton, OR
National Provider Identifier
1033697131
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD214353 Issued in OR
Practice address
15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone
(971) 262-9150
Fax
(971) 262-9151
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD214353 OR Primary

Addresses

Primary practice location

15700 SW Greystone CT
Beaverton, OR 97006-6011

Mailing address

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (971) 262-9150

Other practice location 1

254 Easton Ave
New Brunswick, NJ 08901-1766
Phone (732) 745-8600 ext. 8345

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230824003677 OR Practitioner - Internal Medicine 0840691622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians
Tuality Medical Group LLCGroup PAC ID 7416173414, 289 clinicians

Practice addresses (Care Compare)

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services Current Accepting new patients
Tuality Medical Group LLC CurrentSince Mar 1, 2024 Accepting new patients
University Professional Services CurrentSince Aug 1, 2023 Accepting new patients
Tuality Medical Group LLC Internal Medicine CurrentSince Mar 1, 2024 Accepting new patients
University Professional Services CurrentSince Aug 1, 2023 Accepting new patients
Tuality Healthcare Current Accepting new patients
University Professional Services Past Accepting new patients

Locations

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

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

364 SE 8th Ave
Ste 301
Hillsboro, OR 97123
Phone (503) 681-4233

Interoperability endpoints

  • Direct secure messaging: mjose164871@direct.ohsu.edu

Organizations & group practices 7

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1033697131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15700 SW GREYSTONE CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970066011",
            "telephone_number": "971-262-9150",
            "fax_number": "971-262-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15700 SW GREYSTONE CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970066011",
            "telephone_number": "971-262-9150",
            "fax_number": "971-262-9151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "254 Easton Ave",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "089011766",
            "country_code": "US",
            "telephone_number": "732-745-8600 x8345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSE",
        "first_name": "MERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD214353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.