NPIMap

Individual provider Active NPI

Chad M McCormick, MD

  • Hospitalist Physician
  • Honolulu, HI
National Provider Identifier
1215377312
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD-19935 Issued in HI
Practice address
3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone
(808) 432-0000
NPI assigned
Jul 3, 2013
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD219380 OR
Pediatrics Physician 208000000X 2013020325 MO
Hospitalist Physician 208M00000X MD-19935 HI Primary
Internal Medicine Physician 207R00000X 2013020325 MO
Internal Medicine Physician 207R00000X MD-19935 HI

Addresses

Primary practice location

3288 Moanalua Rd
Honolulu, HI 96819-1469

Mailing address

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000

Other practice location 1

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-6925

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240828000650 OR Practitioner - Infectious Disease 4789818469 Reassigns benefits to 2 organizations
I20240828000985 WA Practitioner - Infectious Disease 4789818469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
University of Missouri St Louis - School of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
96.26
Promoting interoperability
100
Improvement activities
40
Cost
79.84

Merit-based Incentive Payment System (MIPS)

Final score
92.34 of 100Reported as group
Quality
92.55
Promoting interoperability
100
Improvement activities
40
Cost
76.53

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013020325MOMDInternal Medicine Physician
MD219380ORMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital Pediatrics CurrentSince Jul 1, 2024 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jul 1, 2024 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jul 1, 2024 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Jul 1, 2024 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Past Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

6485 SW Borland Rd
Ste F
Tualatin, OR 97062
Phone (503) 413-3580

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1215377312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3288 MOANALUA RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191469",
            "telephone_number": "808-432-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3288 MOANALUA RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191469",
            "telephone_number": "808-432-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 N Gantenbein Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271623",
            "country_code": "US",
            "telephone_number": "503-413-6925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "CHAD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-03",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OR",
            "license": "MD219380",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2013020325",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "HI",
            "license": "MD-19935",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2013020325",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-19935",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3288 Moanalua Rd",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968191469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.