Individual provider Active NPI

Nicholad Kintigh, MSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1154714020
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1904 SE Division St
Portland, OR 97202-1146
Phone
(503) 517-8663
NPI assigned
Mar 16, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1904 SE Division St
Portland, OR 97202-1146

Mailing address

615 NW Naito Pkwy Apt 501
Portland, OR 97209-3890
Phone (503) 729-2431

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231130002796 OR Practitioner - Clinical Social Worker 8729436761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Clackamas Office of County AuditorGroup PAC ID 9537065560, 75 clinicians

Practice addresses (Care Compare)

39740 Pleasant St
Sandy, OR 97055-6412
Phone (503) 655-8471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Clackamas Office of County Auditor CurrentSince Oct 17, 2023 Accepting new patients
Clackamas County Current Accepting new patients
Catholic Community Services of Western Washington Past Accepting new patients

Locations

2051 Kaen Rd
Ste 367
Oregon City, OR 97045
Phone (503) 742-5300

39740 Pleasant St
Sandy, OR 97055
Phone (503) 563-7679

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1154714020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 NW NAITO PKWY APT 501",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093890",
            "telephone_number": "503-729-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021146",
            "telephone_number": "503-517-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINTIGH",
        "first_name": "NICHOLAD",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.