Active NPI
Joseph J Mandiberg, MD
- Orthopaedic Surgery Physician
- Portland, OR
National Provider Identifier
1144214743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MD 11260
- Practice address
- 5050 NE Hoyt St
Suite 640
Portland, OR 97213-2991 - Phone
- (503) 231-1426
- Fax
- (503) 231-0316
- NPI assigned
- Sep 9, 2005
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD 11260 | OR | Primary |
Addresses
Primary practice location
5050 NE Hoyt St
Suite 640
Portland, OR 97213-2991
Mailing address
5050 NE Hoyt St
Suite 640
Portland, OR 97213-2991
Phone (503) 231-1426
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 244731 | 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 |
|---|---|---|---|
| MD 11260 | OR | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379376000000",
"number": "1144214743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5050 NE HOYT ST",
"address_2": "SUITE 640",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132991",
"telephone_number": "503-231-1426",
"fax_number": "503-231-0316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5050 NE HOYT ST",
"address_2": "SUITE 640",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132991",
"telephone_number": "503-231-1426",
"fax_number": "503-231-0316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDIBERG",
"first_name": "JOSEPH",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-09",
"last_updated": "2013-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "OR",
"license": "MD 11260",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "244731",
"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 Sep 17, 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.