Nicholas S. Fogelson, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

173545 Issued in OR

Practice address

511 SW 10TH Ave Ste 907
Portland, OR 97205-2710

Phone

(503) 715-1377

Fax

(503) 715-2717

NPI assigned

Nov 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Nicholas Fogelson MD LLC

  • Gynecology Physician
  • Portland, OR
  • NPI 1316436785
  NPD Authorized official

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1194708081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE STE 907",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052710",
            "telephone_number": "503-715-1377",
            "fax_number": "503-715-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE STE 907",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052710",
            "telephone_number": "503-715-1377",
            "fax_number": "503-715-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGELSON",
        "first_name": "NICHOLAS",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "23610",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "HI",
            "license": "13367",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OR",
            "license": "173545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdul Fofanah
• Clare Fogarty
• Patricia Fogarty, M.D.
• Sean Patrick Fogarty, DNP, PMHNP
• Gerald I Fogel, MD
• Angela Fogg
• Davis Barrett Fogg
• Donna S. Fogg, PSY.D.
• Tabita Luca Foghis
• Weraka Fogi

• Gynecology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Gynecology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.