Active NPI
Mahtab Niyyati
- Internal Medicine Physician
- Portland, OR
National Provider Identifier
1083881296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 225724
- Practice address
- 3515 SW Barbur Blvd Apt X1
Portland, OR 97239-4155 - Phone
- (508) 340-6145
- NPI assigned
- May 15, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 225724 | MA | Primary |
Addresses
Primary practice location
3515 SW Barbur Blvd Apt X1
Portland, OR 97239-4155
Mailing address
3515 SW Barbur Blvd Apt X1
Portland, OR 97239-4155
Phone (508) 340-6145
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
| License | State | Type | Specialty |
|---|---|---|---|
| 225724 | MA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210809600000",
"number": "1083881296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3515 SW BARBUR BLVD APT X1",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394155",
"telephone_number": "508-340-6145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3515 SW BARBUR BLVD APT X1",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394155",
"telephone_number": "508-340-6145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIYYATI",
"first_name": "MAHTAB",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-15",
"last_updated": "2008-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "225724",
"primary": true
}
],
"identifiers": [],
"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 May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.