NPIMap

Individual provider Active NPI

John M Gunselman, D.O.

  • Urology Physician
  • Portland, OR
National Provider Identifier
1194953125
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
DO171400 Issued in OR
Practice address
5050 NE Hoyt St Ste 210
Portland, OR 97213-2980
Phone
(503) 215-7628
NPI assigned
Jun 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X DO171400 OR Primary

Addresses

Primary practice location

5050 NE Hoyt St Ste 210
Portland, OR 97213-2980

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

24076 SE Stark St
Suite 310
Gresham, OR 97030
Phone (503) 492-6510

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jgunselman541123@oc.providencedirect.org
Direct Messaging Address jgunselman541123@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150721001810 OR Practitioner - Urology 4385860352 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Urology LLCGroup PAC ID 2668783770, 14 clinicians

Practice addresses (Care Compare)

2055 NW Savier St
Suite 380
Portland, OR 97209-1770
Phone (503) 223-6223

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
66.66 of 100Reported as group
Quality
61.57
Promoting interoperability
100
Improvement activities
0
Cost
77.29

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO171400ORMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Urology, LLC CurrentSince Jun 1, 2023 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2019 Accepting new patients
Northwest Urological Clinic PC Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2019 Accepting new patients
Urologic Consultants PC Urology Current Accepting new patients

Locations

2055 NW Savier St
Ste 380
Portland, OR 97209

9135 SW Barnes Rd
Ste 663
Portland, OR 97225
Phone (503) 297-1078

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

2230 NW Pettygrove St
Ste 210
Portland, OR 97210

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

Interoperability endpoints

  • Direct secure messaging: john.gunselman.1@11085.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1194953125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST STE 210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132980",
            "telephone_number": "503-215-7628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24076 SE Stark St",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "97030",
            "country_code": "US",
            "telephone_number": "503-492-6510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNSELMAN",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "DO171400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgunselman541123@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 210",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgunselman541123@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 610",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.