Active NPI
Amar Srivastava, M.D.
- Radiation Oncology Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- MD198289
- Practice address
- 4805 NE Glisan St, Garden Level
Portland, OR 97213 - Phone
- (503) 215-6029
- Fax
- (503) 215-6387
- NPI assigned
- May 1, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | MD198289 | OR | Primary |
Addresses
Primary practice location
4805 NE Glisan St, Garden Level
Portland, OR 97213
Mailing address
541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801
Other practice location 1
9205 SW Barnes Rd Lowr Level
Portland, OR 97225-6603
Phone (503) 216-2195
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2162047 | Medicaid | WA | |
| 500779252 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Radiation Oncology
- Education
- Johns Hopkins University School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4805 NE Glisan Garden Level
Portland, OR 97220
Phone (503) 215-6029
Hospital & facility affiliations
- Providence Portland Medical Center
- Providence Willamette Falls Medical Center
- Providence Milwaukie Hospital
- Ohsu Hospital and Clinics
- Providence St Vincent Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD198289 | OR | MD | Radiation Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Oregon Clinic, PC | Current | Accepting new patients | |
| The Oregon Clinic PC | Internal Medicine | Current | Accepting new patients |
Locations
9280 SE Sunnybrook Blvd
Ste 100
Clackamas, OR 97015
Phone (503) 215-1837
847 NE 19th Ave
Ste 300
Portland, OR 97232
9205 SW Barnes Rd
Lowr
Portland, OR 97225
Phone (503) 216-2195
5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673
541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801
4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111
Interoperability endpoints
- asrivastava1267735@oc.providencedirect.org
Organizations & group practices 2
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.
-
- Durable Medical Equipment & Medical Supplies
- Portland, OR
- NPI 1346105129
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003991845
-
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
-
- Case Manager/Care Coordinator
- Portland, OR
- NPI 1891822995
Hospital
-
- General Acute Care Hospital
- Oregon City, OR
- NPI 1912282369
-
- General Acute Care Hospital
- Milwaukie, OR
- NPI 1366536963
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1235549031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 NE 20TH AVE STE 225",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322895",
"telephone_number": "503-963-2801",
"fax_number": "503-963-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4805 NE GLISAN ST, GARDEN LEVEL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97213",
"telephone_number": "503-215-6029",
"fax_number": "503-215-6387"
}
],
"practiceLocations": [
{
"address_1": "9205 SW Barnes Rd Lowr Level",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972256603",
"country_code": "US",
"telephone_number": "503-216-2195",
"fax_number": "503-216-2196",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SRIVASTAVA",
"first_name": "AMAR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-01",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "OR",
"license": "MD198289",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2162047",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500779252",
"state": "OR"
}
],
"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 Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.