NW Internal Medicine

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

166613 Issued in OR

Legal business name

NW INTERNAL MEDICINE

Practice address

5050 NE Hoyt St
Suite 203
Portland, OR 97213-2991

Phone

(503) 230-9224

Fax

(503) 230-9201

NPI assigned

Mar 23, 2015

Last updated

Mar 23, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandy Howard

Title

Office Manager

Phone

(503) 230-9224

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Antonio Pena, MD

  • Specialist
  • Portland, OR
  • NPI 1760531115
  Medicare reassignment NPD
• Gabriel Joseph Francetich, PA-C

  • Physician Assistant
  • Portland, OR
  • NPI 1710497185
  Medicare reassignment
• Porfirio Pena Jr., M.D.

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1255496709
  NPD
• William A Spisak, M.D.

  • Specialist
  • Portland, OR
  • NPI 1740274554
  NPD
• Jeffrey J Horacek, MD

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1790721215
  NPD (past)

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427068800000",
    "number": "1174917603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "SUITE 203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132991",
            "telephone_number": "503-230-9224",
            "fax_number": "503-230-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "SUITE 203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132991",
            "telephone_number": "503-230-9224",
            "fax_number": "503-230-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NW INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-23",
        "last_updated": "2015-03-23",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-230-9224"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "OR",
            "license": "166613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500681386",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NW Clinical Collective
• NW Dermatology and Research Center, LLC (NW Dermatology Institute)
• NW Headache and Wellness Institute PC
• NW Implant Center LLC
• NW Insituto Latino
• NW Medical Center
• NW Neurophysiology Consultants
• NW Neurosurgery LLC
• NW Occupational Medicine Center
• NW Pediatrics Integrative Medicine LLC (NW Pediatrics Integrative Medicine)

• Health Service Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Health Service Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.