Individual provider Active NPI

Thomas O Flath, M.D.,

  • Specialist
  • Portland, OR
National Provider Identifier
1063407690
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD09254 Issued in OR
Practice address
501 N Graham St
Suite 525
Portland, OR 97227-1654
Phone
(503) 249-5454
Fax
(503) 249-5498
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD09254 OR Primary

Addresses

Primary practice location

501 N Graham St
Suite 525
Portland, OR 97227-1654

Mailing address

501 N Graham St
Suite 525
Portland, OR 97227-1654
Phone (503) 249-5454

Other identifiers 1

IdentifierTypeStateIssuer
256412MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD09254ORMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Clinic PC Specialist Current Accepting new patients
Northwest Urology, LLC Specialist Past Accepting new patients
Women'S Healthcare Associates, LLC Specialist PastSince Jul 31, 1999 Accepting new patients

Locations

501 N Graham St
Ste 525
Portland, OR 97227
Phone (503) 249-5454

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.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1063407690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE 525",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271654",
            "telephone_number": "503-249-5454",
            "fax_number": "503-249-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE 525",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271654",
            "telephone_number": "503-249-5454",
            "fax_number": "503-249-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLATH",
        "first_name": "THOMAS",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD09254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256412",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "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 Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.