Individual provider Active NPI

Angela R Hahn, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1093850182
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD21160 Issued in OR
Practice address
9155 SW Barnes Rd Ste 302
Portland, OR 97225-6630
Phone
(503) 291-1777
Fax
(503) 291-1079
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MD21160 OR Primary

Addresses

Primary practice location

9155 SW Barnes Rd Ste 302
Portland, OR 97225-6630

Mailing address

9155 SW Barnes Rd Ste 302
Portland, OR 97225-6630
Phone (503) 291-1777

Other identifiers 1

IdentifierTypeStateIssuer
MD21160OtherORSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, MI, IL, OH, MO, NC, MP7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20070910000089 OR Practitioner - Internal Medicine 6800989799 Reassigns benefits to 1 organization
I20200417000468 MI Practitioner - Internal Medicine 6800989799 Reassigns benefits to 1 organization
I20200504002331 IL Practitioner - Internal Medicine 6800989799 Reassigns benefits to 1 organization
I20200611002832 OH Practitioner - Internal Medicine 6800989799 Reassigns benefits to 1 organization
I20200802000063 MO Practitioner - Internal Medicine 6800989799 Reassigns benefits to 1 organization
I20210212000208 NC Practitioner - Internal Medicine 6800989799 Reassigns benefits to 1 organization
I20210419000612 MP Practitioner - Internal Medicine 6800989799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mi Post Acute Specialists PCGroup PAC ID 6204269483, 28 clinicians

Practice addresses (Care Compare)

145 Columbia Ave
Holland, MI 49423-2981
Phone (610) 820-7638

2510 Lake Michigan Dr NW
Grand Rapids, MI 49504-8042
Phone (616) 301-8800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21160ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Healthcare Corporation CurrentSince Mar 15, 2021 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Mar 15, 2021 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Dec 1, 2012 Accepting new patients
Legacy Clinics LLC Past Accepting new patients

Locations

2870 SW Cedar Hills Blvd
Beaverton, OR 97005
Phone (503) 646-9222

9155 SW Barnes Rd
Ste 302
Portland, OR 97225
Phone (503) 291-1777

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

Interoperability endpoints

  • Direct secure messaging: angela.hahn.1@19814.direct.athenahealth.com

Organizations & group practices 6

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093850182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 302",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256630",
            "telephone_number": "503-291-1777",
            "fax_number": "503-291-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 302",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256630",
            "telephone_number": "503-291-1777",
            "fax_number": "503-291-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAHN",
        "first_name": "ANGELA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD21160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD21160",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.