Michael Vincent Mesa, DO

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

DO21359 Issued in OR

Practice address

8192 SW Durham Rd
Tigard, OR 97224-7315

Phone

(503) 257-5568

Fax

(503) 257-5566

NPI assigned

Mar 30, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Extremity Specialists LLCGroup PAC ID 3577881747, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Medsurg Pathology Associates PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Portland, OR
  • NPI 1053585497
  Medicare reassignment NPD Authorized official
• Northwest Extremity Specialists LLC

  • Podiatrist
  • Portland, OR
  • NPI 1295126241
  Medicare reassignment Care Compare group NPD
• Medsurg Pathology Associates PC

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1902146392
  NPD (past) Authorized official
• Mesa Clinical Laboratories, PC

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1013169499
  NPD (past) Authorized official
• Northwest Extremity Specialists LLC

  dba NES Wilsonville

  • Podiatric Clinic/Center
  • Wilsonville, OR
  • NPI 1346973039
  NPD
• Cutting Edge Histology Services LLC

  • Clinical Medical Laboratory
  • Tigard, OR
  • NPI 1881867596
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1184744351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8192 SW DURHAM RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247315",
            "telephone_number": "503-257-5568",
            "fax_number": "503-257-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8192 SW DURHAM RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247315",
            "telephone_number": "503-257-5568",
            "fax_number": "503-257-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESA",
        "first_name": "MICHAEL",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OR",
            "license": "DO21359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134082",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Mendy, PT
• Stephanie J Mengden Koon, M.D.
• Helmar Menz
• Mercy Residential Treatment Facility
• Chelsea Noel Mersereau
• Candy Lynn Metelak, CRM, PRC, CADC I
• Metis Clinics
• Metis Clinics
• Metis Clinics LLC
• Metis Clinics LLC

• Anatomic Pathology & Clinical Pathology Physician in Tigard, OR
• Providers in Tigard, OR by specialty
• Anatomic Pathology & Clinical Pathology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.