Active NPI
Amnon Sonnenberg, MD
- Gastroenterology Physician
- Portland, OR
National Provider Identifier
1124033626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- LL16137
- Practice address
- 3710 SW US Veterans Hospital Rd
Portland VA Medical Center, P3-Gi
Portland, OR 97239-2964 - Phone
- (503) 220-8262
- Fax
- (503) 220-3426
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | LL16137 | OR | Primary |
Addresses
Primary practice location
3710 SW US Veterans Hospital Rd
Portland VA Medical Center, P3-Gi
Portland, OR 97239-2964
Mailing address
3710 SW US Veterans Hospital Rd
Portland VA Medical Center, P3-Gi
Portland, OR 97239-2964
Phone (503) 220-8262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227422 | Medicaid | OR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL16137 | OR | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184284800000",
"number": "1124033626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3710 SW US VETERANS HOSPITAL RD",
"address_2": "PORTLAND VA MEDICAL CENTER, P3-GI",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392964",
"telephone_number": "503-220-8262",
"fax_number": "503-220-3426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3710 SW US VETERANS HOSPITAL RD",
"address_2": "PORTLAND VA MEDICAL CENTER, P3-GI",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392964",
"telephone_number": "503-220-8262",
"fax_number": "503-220-3426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONNENBERG",
"first_name": "AMNON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "OR",
"license": "LL16137",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "227422",
"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 Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.