Jeffrey Aaron Komisarof, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD26611 Issued in OR

Practice address

10201 SE Main St
Suite 27
Portland, OR 97216-2937

Phone

(503) 256-0877

Fax

(503) 256-4188

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Critical Care (Intensivists)Also: Internal Medicine, Nephrology

Education

Perelman School of Med at the University of Pennsylvania, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

National Capital Nephrology PCGroup PAC ID 7214921030, 2 clinicians

Capital Critical Care, LLCGroup PAC ID 6709037179, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rai - Chillum-Washington Dialysis facility, Washington, DC, CCN 092527
• DaVita Mt. Rainier Dialysis Dialysis facility, Mount Rainier, MD, CCN 212720
• Holy Cross Hospital Hospital, Silver Spring, MD, CCN 210004
• Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: jkomisarof1144218@direct.trinity-health.org

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.

• Capital Critical Care, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Rockville, MD
  • NPI 1588910566

  DC

  Medicare reassignment Care Compare group
• National Capital Nephrology, PC

  • Nephrology Physician
  • Washington, DC
  • NPI 1912177049
  Medicare reassignment Care Compare group
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Hyattsville Dialysis, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mount Rainier, MD
  • NPI 1457706467

  Dialysis facility

  Care Compare affiliation Name & address match
• Rai Care Centers of DC I, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Washington, DC
  • NPI 1184934200

  Dialysis facility

  Care Compare affiliation Name & address match
• Holy Cross Health, Inc

  • General Acute Care Hospital
  • Silver Spring, MD
  • NPI 1669417838
  Care Compare affiliation
• Holy Cross Health, Inc.

  • Clinical Medical Laboratory
  • Silver Spring, MD
  • NPI 1831574284

  Hospital

  Care Compare affiliation
• Medstar Washington Hospital Center

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1548378235
  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043318405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 SE MAIN ST",
            "address_2": "SUITE 27",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162937",
            "telephone_number": "503-256-0877",
            "fax_number": "503-256-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 SE MAIN ST",
            "address_2": "SUITE 27",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162937",
            "telephone_number": "503-256-0877",
            "fax_number": "503-256-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMISAROF",
        "first_name": "JEFFREY",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OR",
            "license": "MD26611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Jordan Komer, PT, DPT, OLS
• Radko Komers, M.D.
• Anastasia Elizabeth-Rios Komfolio
• Tessa Komine, MS, RDN, LD, CD
• Cameron James Komisar, ND
• Christopher Komisarz, DO, MPH
• Kari Michelle Komlofske, FNP-C
• Alexander Kondra
• Angela Michelle Kondrat, MD
• Monicka April Koneski, LMT, RYT

• Nephrology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Nephrology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.