Individual provider Active NPI

Molly A Conroy

  • General Practice Physician
  • Portland, OR
National Provider Identifier
1154827533
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD206565 Issued in OR
Practice address
3601 S River Pkwy
Portland, OR 97239-4553
Phone
(503) 679-5349
NPI assigned
Apr 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD206565 OR Primary

Addresses

Primary practice location

3601 S River Pkwy
Portland, OR 97239-4553

Mailing address

MSC General Surgery 1 University of New Mexico
Albuquerque, NM 87131-0001

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
I20240131003391 OR Practitioner - General Practice 5597013904 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD206565ORMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Dec 10, 2024 Accepting new patients
Pro Health One Inc CurrentSince Jan 18, 2024 Accepting new patients
American Current Care P.a. CurrentSince Dec 10, 2024 Accepting new patients

Locations

8181 E Tufts Ave
Ste 560
Denver, CO 80237
Phone (888) 972-8596

5905 SE Powell Valley Rd
Gresham, OR 97080
Phone (503) 665-1151

6405 Rosewood St
Ste B
Lake Oswego, OR 97035
Phone (503) 675-7603

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1154827533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC GENERAL SURGERY 1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S RIVER PKWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394553",
            "telephone_number": "503-679-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "MOLLY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OR",
            "license": "MD206565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.