Individual provider Active NPI

David Ehrman, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1164135091
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L6974 Issued in OR
Practice address
1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone
(503) 413-6209
NPI assigned
Jan 5, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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 L6974 OR Primary

Addresses

Primary practice location

1200 NW 23Rd Ave
Portland, OR 97210-2906

Mailing address

5281 NW Wickiup Way
Portland, OR 97229-7160
Phone (503) 780-6656

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
I20230222000930 OR Practitioner - Clinical Social Worker 3678946688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074

Merit-based Incentive Payment System (MIPS)

Final score
92.34 of 100Reported as group
Quality
92.55
Promoting interoperability
100
Improvement activities
40
Cost
76.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jan 19, 2023 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jan 19, 2023 Accepting new patients

Locations

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

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": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1164135091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5281 NW WICKIUP WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972297160",
            "telephone_number": "503-780-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NW 23RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102906",
            "telephone_number": "503-413-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRMAN",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.