Individual provider Active NPI

Wilfred Arthur Geschke, M.D.

  • Hematology (Internal Medicine) Physician
  • Portland, OR
National Provider Identifier
1114920055
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
MD09390 Issued in OR
Practice address
10101 SE Main St
Suite 1012
Portland, OR 97216-2455
Phone
(503) 256-3627
Fax
(503) 252-8983
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X MD09390 OR Primary

Addresses

Primary practice location

10101 SE Main St
Suite 1012
Portland, OR 97216-2455

Mailing address

10101 SE Main St
Suite 1012
Portland, OR 97216-2455
Phone (503) 256-3627

Other identifiers 2

IdentifierTypeStateIssuer
1002793MedicaidWA
072744MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Cancer Specialists PC Past Accepting new patients
Northwest Cancer Specialists PC PastSince Jan 1, 2000 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1114920055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 SE MAIN ST",
            "address_2": "SUITE 1012",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162455",
            "telephone_number": "503-256-3627",
            "fax_number": "503-252-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 SE MAIN ST",
            "address_2": "SUITE 1012",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162455",
            "telephone_number": "503-256-3627",
            "fax_number": "503-252-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GESCHKE",
        "first_name": "WILFRED",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "OR",
            "license": "MD09390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002793",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "072744",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.