Active NPI
Manish Thakur, D.O.
- Diagnostic Radiology Physician
- Portland, OR
National Provider Identifier
1144593567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 169963
- Practice address
- 9205 SW Barnes Rd
Portland, OR 97225-6603 - Phone
- (203) 415-1023
- Fax
- (203) 415-1023
- NPI assigned
- Feb 15, 2012
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 169963 | OR | Primary |
Addresses
Primary practice location
9205 SW Barnes Rd
Portland, OR 97225-6603
Mailing address
PO Box 25180
Portland, OR 97298-0180
Phone (203) 415-1023
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 169963 | Other | OR | OREGON MEDICAL LICENSE DO |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 169963 | OR | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1144593567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 25180",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972980180",
"telephone_number": "203-415-1023",
"fax_number": "203-415-0123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9205 SW BARNES RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256603",
"telephone_number": "203-415-1023",
"fax_number": "203-415-1023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAKUR",
"first_name": "MANISH",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-15",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OR",
"license": "169963",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON MEDICAL LICENSE DO",
"identifier": "169963",
"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 Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.