Individual provider Active NPI

Thomas Patrick Welch, MD

  • Psychiatry Physician
  • Aloha, OR
National Provider Identifier
1083626121
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD17971 Issued in OR
Practice address
4585 SW 185TH Ave
Aloha, OR 97078
Phone
(503) 591-9280
Fax
(503) 848-2072
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD17971 OR Primary

Addresses

Primary practice location

4585 SW 185TH Ave
Aloha, OR 97078

Mailing address

4585 SW 185TH Ave
Aloha, OR 97078-1557
Phone (503) 591-9280

Other practice location 1

8383 NE Sandy Blvd
Ste 205
Portland, OR 97220-4967
Phone (503) 292-4382

Other identifiers 1

IdentifierTypeStateIssuer
F07035MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20161003000256 OR Practitioner - Psychiatry 6204912892 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17971MDMDPharmacist
MD17971ORMDPsychiatry Physician
17971ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sequoia Mental Health Services Inc Community/Behavioral Health CurrentSince Nov 19, 2019 Accepting new patients
Cascadia Health Past Accepting new patients

Locations

4585 SW 185th Ave
Beaverton, OR 97078

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1083626121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4585 SW 185TH AVE",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970781557",
            "telephone_number": "503-591-9280",
            "fax_number": "503-848-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 SW 185TH AVE",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "97078",
            "telephone_number": "503-591-9280",
            "fax_number": "503-848-2072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8383 NE SANDY BLVD",
            "address_2": "STE 205",
            "address_purpose": "LOCATION",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204967",
            "country_code": "US",
            "telephone_number": "503-292-4382",
            "fax_number": "503-292-4392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELCH",
        "first_name": "THOMAS",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD17971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F07035",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aloha, OR

Sources for this page

Verify at the official NPI Registry.