NPIMap

Organization Active NPI

Open Advanced MRI Portland III, LLC

  • Diagnostic Radiology Physician
  • Portland, OR
National Provider Identifier
1184670754
Registry record updated Oct 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
OPEN ADVANCED MRI PORTLAND III, LLC
Practice address
11750 SE 82ND Ave
#J
Portland, OR 97266-7727
Phone
(503) 653-1699
Fax
(503) 653-3899
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2009

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

Authorized official

Name
Levent Adam
Title
Director of Operations
Phone
(703) 970-2892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

11750 SE 82ND Ave
#J
Portland, OR 97266-7727

Mailing address

PO Box 75469
Baltimore, MD 21275-5469
Phone (503) 657-8663

Other identifiers 2

IdentifierTypeStateIssuer
130242MedicaidOR
7114648MedicaidWA

National Provider Directory

National Provider Directory

Locations

11750 SE 82nd Ave
Ste J
Portland, OR 97086
Phone (503) 653-1699

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256601600000",
    "number": "1184670754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75469",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212755469",
            "telephone_number": "503-657-8663",
            "fax_number": "503-723-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 SE 82ND AVE",
            "address_2": "#J",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972667727",
            "telephone_number": "503-653-1699",
            "fax_number": "503-653-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN ADVANCED MRI PORTLAND III, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2009-10-27",
        "status": "A",
        "authorized_official_last_name": "ADAM",
        "authorized_official_first_name": "LEVENT",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "703-970-2892"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130242",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7114648",
            "state": "WA"
        }
    ],
    "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 Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.