Individual provider Active NPI

Emmanuel Dwomoh-Tweneboah, AGACNP

  • Acute Care Nurse Practitioner
  • Portland, OR
National Provider Identifier
1124529243
Registry record updated Mar 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
201710153NP-PP Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-9000
NPI assigned
Feb 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 201710153NP-PP OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-4373

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180409002163 OR Practitioner - Nurse Practitioner 1951664762 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Oregon Health Sciences University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesiology Associates LLCGroup PAC ID 6901702869, 239 clinicians

Practice addresses (Care Compare)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-7641

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
98.65
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201710153NP-PPORMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesiology Associates, LLC CurrentSince Oct 1, 2020 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Mar 19, 2025 Accepting new patients
University Professional Services CurrentSince Apr 1, 2018 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Mar 19, 2025 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Apr 1, 2018 Accepting new patients
Oregon Health & Science University CurrentSince Apr 1, 2018 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Oregon Health & Science University CurrentSince Apr 1, 2018 Accepting new patients
Oregon Health & Science University Current Accepting new patients
Tuality Medical Group LLC CurrentSince May 1, 2024 Accepting new patients
Tuality Medical Group LLC CurrentSince May 1, 2024 Accepting new patients
Legacy Clinics LLC CurrentSince Jun 1, 2023 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

707 SW Gaines St
Portland, OR 97239
Phone (503) 492-2709

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

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

501 N Graham St
Ste 200
Portland, OR 97227
Phone (503) 413-4488

501 N Graham St
Ste 220
Portland, OR 97227
Phone (503) 413-4710

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

Interoperability endpoints

  • Direct secure messaging: edwomohtweneboahrn7690@direct.ohsu.edu

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520035200000",
    "number": "1124529243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-4373",
            "fax_number": "503-418-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWOMOH-TWENEBOAH",
        "first_name": "EMMANUEL",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201710153NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.