NPIMap

Individual provider Active NPI

Michael David Skokan, MD

  • Pulmonary Disease Physician
  • Portland, OR
National Provider Identifier
1245223395
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD22956 Issued in OR
Practice address
1111 NE 99TH Ave Ste 200
Portland, OR 97220-9442
Phone
(503) 963-3030
Fax
(503) 963-3140
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD22956 OR Primary

Addresses

Primary practice location

1111 NE 99TH Ave Ste 200
Portland, OR 97220-9442

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other identifiers 2

IdentifierTypeStateIssuer
8271744MedicaidWA
287876MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referringpulm@1243.direct.myezyaccess.com The Oregon Clinic PC

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
I20040524000204 OR Practitioner - Pulmonary Disease 5193716520 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Oregon Health Sciences University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians
Providence Health and Services - OregonGroup PAC ID 5395656284, 195 clinicians

Practice addresses (Care Compare)

1111 NE 99TH Ave
Portland, OR 97220-9442

4805 NE Glisan
Portland, OR 97213-2933

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

Hospital & facility affiliations

  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
  • Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318

Merit-based Incentive Payment System (MIPS)

Final score
95.53 of 100Reported as group
Quality
96.2
Promoting interoperability
100
Improvement activities
40
Cost
84.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD22956ORMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic, PC CurrentSince May 1, 2001 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 12, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 23, 2018 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 12, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 23, 2018 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jul 1, 2007 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 24, 2017 Accepting new patients
The Oregon Clinic PC Pulmonary Disease CurrentSince May 1, 2001 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2007 Accepting new patients

Locations

200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

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

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

847 NE 19th Ave
Ste 300
Portland, OR 97232

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

1111 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 216-5435

Interoperability endpoints

  • Direct secure messaging: mskokan133648@oc.providencedirect.org

Organizations & group practices 10

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 6

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1245223395",
    "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": "1111 NE 99TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209442",
            "telephone_number": "503-963-3030",
            "fax_number": "503-963-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOKAN",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD22956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8271744",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287876",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referringpulm@1243.direct.myezyaccess.com",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "1111 NE 99th Ave Ste 200",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972209442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.