Bobak Amir Ghaheri, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD27404 Issued in OR

Practice address

24076 SE Stark St
Suite 230
Gresham, OR 97030-3373

Phone

(503) 488-2600

Fax

(503) 465-5468

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Bobby Amir Ghaheri Other name

Electronic endpoints 1

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

Specialty

Otolaryngology

Education

Ohio State University College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bghaheri132816@oc.providencedirect.org

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.

• The Oregon Clinic PC

  • Specialist
  • Portland, OR
  • NPI 1265417174
  Medicare reassignment Care Compare group NPD
• The Oregon Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
  • NPI 1346105129
  NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1114098696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "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": "24076 SE STARK ST",
            "address_2": "SUITE 230",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-488-2600",
            "fax_number": "503-465-5468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 NE 99th Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972209442",
            "country_code": "US",
            "telephone_number": "503-488-2626",
            "fax_number": "503-488-2630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHAHERI",
        "first_name": "BOBAK",
        "middle_name": "AMIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD27404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8481699",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006246",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_ent_east_front_desk_pool12223123@or.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "24076 SE Stark St",
            "address_2": "Suite 230",
            "city": "Gresham",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970303373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BOBBY",
            "last_name": "GHAHERI",
            "middle_name": "AMIR",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Feven Gebremeskel, RN
• Mark A. George, O.D.
• Myron J George, LCSW
• Brooke Alexandria Geske, OTD
• Taunya Marie Gesner, LPC
• Vanessa Marie Giannattasio
• Angela Gibbs, MD
• Sarah Gibney, LCSW
• Britanee Gifford
• Gifted Hands in-Home Care Agency LLC

• Otolaryngology Physician in Gresham, OR
• Providers in Gresham, OR by specialty
• Otolaryngology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.