Individual provider Active NPI

Ora Naomi Botwinick, MD

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1093866634
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD17563 Issued in OR
Practice address
9000 N Lombard St
Portland, OR 97203-3006
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD17563 OR Primary

Addresses

Primary practice location

9000 N Lombard St
Portland, OR 97203-3006

Mailing address

421 SW Oak St
210
Portland, OR 97204-1817
Phone (503) 988-3674

Other practice location 1

426 SW Stark St
8TH Floor
Portland, OR 97204-2347
Phone (503) 988-3674

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
I20100414000791 OR Practitioner - Family Practice 3375670896 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17563ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County Current Accepting new patients
Multnomah County CurrentSince Feb 25, 2010 Accepting new patients
Multnomah County CurrentSince Feb 25, 2010 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674

9000 N Lombard St
Portland, OR 97203
Phone (503) 988-5304

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.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1093866634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SW OAK ST",
            "address_2": "210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041817",
            "telephone_number": "503-988-3674",
            "fax_number": "503-988-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 N LOMBARD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972033006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "426 SW Stark St",
            "address_2": "8TH FLOOR",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972042347",
            "country_code": "US",
            "telephone_number": "503-988-3674",
            "fax_number": "503-988-5305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTWINICK",
        "first_name": "ORA",
        "middle_name": "NAOMI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD17563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.