John Guy Mastronarde, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

MD173777 Issued in OR

Practice address

1111 NE 99TH Ave
Portland, OR 97220-9428

Phone

(503) 963-3030

Fax

(503) 963-3140

NPI assigned

Aug 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Osu Internal Medicine, LLC

  • Endoscopy Clinic/Center
  • Dublin, OH
  • NPI 1427127919
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1093828634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322684",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 NE 99TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209428",
            "telephone_number": "503-963-3030",
            "fax_number": "503-963-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRONARDE",
        "first_name": "JOHN",
        "middle_name": "GUY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35059362",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35059362",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD173777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0786690",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2046986",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129950",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Masters, PMHNP
• Kari Masterson
• Rachael Masterson, PA-C
• Brittany Mastin, D.O.
• Mark W Mastrandrea, MD
• Mackenna Rae Mastrud, LAC
• Garrett Masuda, DDS, MS
• Connie Lei Masuoka, D.M.D.
• Emeliana Tauanuu Mata
• Brandon L. Matacic, PHARMD

• Pulmonary Disease Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pulmonary Disease Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.