Portland Adventist Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14 1127 Issued in OR

Legal business name

PORTLAND ADVENTIST MEDICAL CENTER

Doing business as

Adventist Health Portland

Practice address

10000 SE Main St
Suite 116
Portland, OR 97216

Phone

(503) 251-6354

Fax

(503) 251-6286

NPI assigned

Nov 22, 2005

Last updated

Jan 6, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

PORTLAND ADVENTIST MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Kyle King

Title

Ceo

Phone

(503) 251-6842

Specialties & licenses 12

Addresses

Other identifiers 4

Other names 1

• ADVENTIST HEALTH PORTLAND Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Portland Adventist Medical Center

  dba Adventist Health Portland

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1801887658

  7012827876

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Portland Adventist Medical Center

  dba Adventist Health Portland

  • Emergency Medical Services (Emergency Medicine) Physician
  • Portland, OR
  • NPI 1316502719

  O20040226000131

  Same enrollment

Part of

Portland Lung Inst

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Portland Adventist Medical Center

  dba Adventist Health Portland

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1801887658
  NPPES parent name

Practitioners 158

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fawaz S Alhumaid, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Portland, OR
  • NPI 1255515938
  Medicare reassignment NPD
• Kamaljit K Atwal, DO

  • Pulmonary Disease Physician
  • Portland, OR
  • NPI 1821053356
  Medicare reassignment NPD
• Carrie R Austin, MD

  • Hospitalist Physician
  • Portland, OR
  • NPI 1922411412

  Internal Medicine

  Medicare reassignment NPD
• Breanna Nicole Baraff, FNP

  • Family Nurse Practitioner
  • Portland, OR
  • NPI 1336783190
  Medicare reassignment NPD
• Jonathan D Benton, DO

  • Family Medicine Physician
  • Troutdale, OR
  • NPI 1619534104
  Medicare reassignment NPD
• Emily C Bier, M.D.

  • Family Medicine Physician
  • Troutdale, OR
  • NPI 1043268196
  Medicare reassignment NPD
• Jacob R Blair, MD

  • Hospitalist Physician
  • Portland, OR
  • NPI 1447639430

  Internal Medicine

  Medicare reassignment NPD
• Erin Rose Boehm, MD

  • Cardiovascular Disease Physician
  • Portland, OR
  • NPI 1164788808
  Medicare reassignment NPD
• Ameet S Brahmavar, MD

  • Emergency Medicine Physician
  • Portland, OR
  • NPI 1205959947
  Medicare reassignment NPD
• Richard W Brandes, MD

  • Gastroenterology Physician
  • Portland, OR
  • NPI 1750420766
  Medicare reassignment NPD
• Heather N Brown, MD

  • Hospitalist Physician
  • Portland, OR
  • NPI 1972569432

  Internal Medicine

  Medicare reassignment NPD
• Kevin Bruce, M.D.

  • Hospitalist Physician
  • Portland, OR
  • NPI 1598961799

  Internal Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641427200000",
    "number": "1215910302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888918",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900888918",
            "telephone_number": "503-261-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST",
            "address_2": "SUITE 116",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97216",
            "telephone_number": "503-251-6354",
            "fax_number": "503-251-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND ADVENTIST MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PORTLAND ADVENTIST MEDICAL CENTER",
        "enumeration_date": "2005-11-22",
        "last_updated": "2022-01-06",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-251-6842"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "OR",
            "license": "14 1127",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "14 1127",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "14 1127",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "14 1127",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "14 1127",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "14 1127",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OR",
            "license": "14 1127",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "OR",
            "license": "14 1127",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "14 1127",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "14 1127",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "OR",
            "license": "14 1127",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I (OCCMED CLINIC)",
            "identifier": "0201918",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE OR CLIN",
            "identifier": "CI4927",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "0127633",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE WA CLIN",
            "identifier": "CH2083",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVENTIST HEALTH PORTLAND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jahir Portillo
• Midori Portillo
• Natalie Faith Portis
• Portland Acupuncture Group
• Portland Adventist Community Services
• Portland Adventist Medical Center (Adventist Health Portland)
• Portland Adventist Medical Center (Adventist Health Home Infusion Therapy)
• Portland Adventist Medical Center (Adventist Health Home Care)
• Portland Adventist Medical Center (Adventist Medical Center DME)
• Portland Adventist Medical Center (Adventist Health Medical Group)

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.