Individual provider Active NPI

Amulya Prabhala, MD

  • Student in an Organized Health Care Education/Training Program
  • Hillsboro, OR
National Provider Identifier
1124812532
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone
(503) 681-1111
NPI assigned
Apr 9, 2025
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

335 SE 8TH Ave
Hillsboro, OR 97123-4246

Mailing address

15390 SW Kiwanda LN
Beaverton, OR 97007-5048
Phone (503) 207-8365

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250718003848 OR Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5698281418

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: aprabhala134775@direct.ohsu.edu

NPI Registry JSON

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1124812532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15390 SW KIWANDA LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970075048",
            "telephone_number": "503-207-8365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 SE 8TH AVE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234246",
            "telephone_number": "503-681-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHALA",
        "first_name": "AMULYA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.