Individual provider Active NPI

Ahmad Jaffas

  • Peer Specialist
  • Portland, OR
National Provider Identifier
1194403071
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
7931 NE Halsey St Ste 200
Portland, OR 97213-6755
Phone
(503) 231-7480
NPI assigned
Jul 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

7931 NE Halsey St Ste 200
Portland, OR 97213-6755

Mailing address

7931 NE Halsey St Ste 200
Portland, OR 97213-6755
Phone (503) 231-7480

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Community Services Northwest PastSince Jul 16, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1194403071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7931 NE HALSEY ST STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136755",
            "telephone_number": "503-231-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7931 NE HALSEY ST STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136755",
            "telephone_number": "503-231-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFAS",
        "first_name": "AHMAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 11, 2023; 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.