Individual provider Active NPI

Daphne A Sy, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1114417888
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD61203240 Issued in WA
Practice address
9205 SW Barnes Rd Ste Mt2800
Portland, OR 97225-6603
Phone
(503) 216-2621
NPI assigned
May 17, 2018
Last updated
Aug 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PG188408 OR
Internal Medicine Physician 207R00000X MD61203240 WA Primary

Addresses

Primary practice location

9205 SW Barnes Rd Ste Mt2800
Portland, OR 97225-6603

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 717-7147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20211230000542 WA Practitioner - Internal Medicine 1355698838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Western Michigan Un Homer Stryker School of Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
96.26
Promoting interoperability
100
Improvement activities
40
Cost
79.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61203240WAMDInternal Medicine Physician
PG188408ORMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Dec 27, 2021 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Dec 27, 2021 Accepting new patients

Locations

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1114417888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-717-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD STE MT2800",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256603",
            "telephone_number": "503-216-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SY",
        "first_name": "DAPHNE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-17",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "PG188408",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61203240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.