Individual provider Active NPI

Henre James Andosca, DC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1164460838
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3326 Issued in OR
Practice address
1836 NE 7TH Ave Ste 109
Portland, OR 97212-3978
Phone
(503) 506-5120
Fax
(503) 506-5121
NPI assigned
Jun 3, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3326 OR Primary

Addresses

Primary practice location

1836 NE 7TH Ave Ste 109
Portland, OR 97212-3978

Mailing address

1836 NE 7TH Ave Ste 109
Portland, OR 97212-3978
Phone (503) 506-5120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180213001527 OR Practitioner - Chiropractic 9537132410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

435 NE Tillamook St
Portland, OR 97212-3850
Phone (503) 506-5120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3326ORMDChiropractor
2690MAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
120 Chiropractic Inc. Chiropractor CurrentSince Jan 1, 2002 Accepting new patients
Easthampton Chiropractic Center LLC Chiropractor PastSince Sep 10, 2020 Accepting new patients
Easthampton Chiropractic Center LLC Chiropractor PastSince Nov 30, 2016 Accepting new patients

Locations

1836 NE 7th Ave
Ste 109
Portland, OR 97212
Phone (503) 383-9555

435 NE Tillamook St
Portland, OR 97212
Phone (503) 506-5120

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164460838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 NE 7TH AVE STE 109",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123978",
            "telephone_number": "503-506-5120",
            "fax_number": "503-506-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 NE 7TH AVE STE 109",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123978",
            "telephone_number": "503-506-5120",
            "fax_number": "503-506-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDOSCA",
        "first_name": "HENRE",
        "middle_name": "JAMES",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3326",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.