Active NPI
Milan Sosnovec, MD
- Psychiatry Physician
- Beaverton, OR
National Provider Identifier
1174795843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD10928
- Practice address
- 12250 SW 2ND St
Suite #102
Beaverton, OR 97005-2828 - Phone
- (503) 292-6238
- Fax
- (503) 601-0049
- NPI assigned
- Apr 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD10928 | OR | Primary |
Addresses
Primary practice location
12250 SW 2ND St
Suite #102
Beaverton, OR 97005-2828
Mailing address
12250 SW 2ND St
Suite #102
Beaverton, OR 97005-2828
Phone (503) 292-6238
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 184747 | Medicaid | OR |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD10928 | OR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471392000000",
"number": "1174795843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12250 SW 2ND ST",
"address_2": "SUITE #102",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970052828",
"telephone_number": "503-292-6238",
"fax_number": "503-601-0049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12250 SW 2ND ST",
"address_2": "SUITE #102",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970052828",
"telephone_number": "503-292-6238",
"fax_number": "503-601-0049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOSNOVEC",
"first_name": "MILAN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-02",
"last_updated": "2016-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "MD10928",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184747",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.