NPIMap

Individual provider Active NPI

Siddharth Bhikhubhai Javia, M.D.

  • Gastroenterology Physician
  • Portland, OR
National Provider Identifier
1174811608
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD219156 Issued in OR
Practice address
3303 S Bond Ave
Portland, OR 97239-4501
Phone
(503) 494-4373
Fax
(503) 418-4189
NPI assigned
Jul 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD60787977 WA
Internal Medicine Physician 207R00000X MD219156 OR
Gastroenterology Physician 207RG0100X MD219156 OR Primary

Addresses

Primary practice location

3303 S Bond Ave
Portland, OR 97239-4501

Mailing address

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-4373

Other practice location 1

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 663-8711

Other practice location 2

1015 NW 22nd Ave
Portland, OR 97210-3025
Phone (503) 413-7878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180612002652 WA Practitioner - Gastroenterology 4385999531 Reassigns benefits to 1 organization
I20240506000911 OR Practitioner - Gastroenterology 4385999531 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Good Samaritan Hospital and Medical CenterGroup PAC ID 0547179939, 190 clinicians
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7582

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150
  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy15
Upper gastrointestinal (GI) endoscopy for acid reflux213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD219156ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wenatchee Valley Hospital Current Accepting new patients
University Professional Services CurrentSince Jul 1, 2024 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Apr 12, 2024 Accepting new patients
University Professional Services CurrentSince Jul 1, 2024 Accepting new patients
University Professional Services Current Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Apr 12, 2024 Accepting new patients
Wenatchee Valley Hospital CurrentSince Jul 1, 2018 Accepting new patients
University Professional Services Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

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

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

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

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

Interoperability endpoints

  • Direct secure messaging: sjavia173916@direct.ohsu.edu

Organizations & group practices 9

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1174811608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-4373",
            "fax_number": "503-418-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-4373",
            "fax_number": "503-418-4189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 N Chelan Ave",
            "address_purpose": "LOCATION",
            "city": "Wenatchee",
            "state": "WA",
            "postal_code": "98801",
            "country_code": "US",
            "telephone_number": "509-663-8711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 NW 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972103025",
            "country_code": "US",
            "telephone_number": "503-413-7878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAVIA",
        "first_name": "SIDDHARTH",
        "middle_name": "BHIKHUBHAI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-18",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD60787977",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD219156",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "MD219156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.