NPIMap

Individual provider Active NPI

Emma Davidson Peiris, M.D.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1063830693
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD182343 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-8211
NPI assigned
Apr 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD182343 OR Primary

Addresses

Primary practice location

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

Mailing address

1700 E 19TH St
The Dalles, OR 97058-3317
Phone (541) 506-5710

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
I20170720002343 OR Practitioner - Internal Medicine 7911125612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
East Tennessee State University Quillen College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grande Ronde Hospital IncGroup PAC ID 0547170789, 97 clinicians

Practice addresses (Care Compare)

900 Sunset Dr
La Grande, OR 97850-1362

900 Sunset Dr
La Grande, OR 97850-1387
Phone (541) 963-8421

PO Box
Suite 3290
La Grande, OR 97850

PO Box
Suite 3290
La Grande, OR 97850-7290

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, La Grande, OR, CCN 387150
  • Grande Ronde Hospital Home Care Services Home health agency, La Grande, OR, CCN 387037
  • Heart N Home Hospice & Palliative Care Hospice, Fruitland, ID, CCN 131545
  • Grande Ronde Hospital Hospital, La Grande, OR, CCN 381321
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • St Anthony Hospital Hospital, Pendleton, OR, CCN 381319

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grande Ronde Hospital, Inc. CurrentSince Apr 4, 2022 Accepting new patients
Grande Ronde Hospital, Inc. CurrentSince Apr 4, 2022 Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients

Locations

900 Sunset Dr
La Grande, OR 97850
Phone (541) 963-8421

506 4th St
La Grande, OR 97850
Phone (541) 663-3138

Interoperability endpoints

  • Direct secure messaging: epeiris561600@wm.providencedirect.org

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.

Hospital & facility affiliations 10

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1063830693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E 19TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583317",
            "telephone_number": "541-506-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEIRIS",
        "first_name": "EMMA",
        "middle_name": "DAVIDSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD182343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.