Individual provider Active NPI

Hetal Kumudchandra Fichadia, MD

  • Plastic Surgery Physician
  • Portland, OR
National Provider Identifier
1245406784
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD170906 Issued in OR
Practice address
9155 SW Barnes Rd Ste 532
Portland, OR 97225-6632
Phone
(503) 488-2344
Fax
(503) 488-2360
NPI assigned
May 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X MD170906 OR
Plastic Surgery Physician 208200000X MD170906 OR Primary

Addresses

Primary practice location

9155 SW Barnes Rd Ste 532
Portland, OR 97225-6632

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2026298MedicaidWA
500654757MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referringpsd@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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150715000050 OR Practitioner - Plastic and Reconstructive Surgery 9638323918 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

9155 SW Barnes Rd
Suite 440
Portland, OR 97225-6631
Phone (503) 935-8500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy14
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD170906ORMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic, PC CurrentSince Aug 1, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2015 Accepting new patients
The Oregon Clinic PC CurrentSince Aug 1, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2015 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2015 Accepting new patients

Locations

847 NE 19th Ave
Ste 300
Portland, OR 97232

9155 SW Barnes Rd
Ste 440
Portland, OR 97225
Phone (503) 297-3766

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

9155 SW Barnes Rd
Ste 532
Portland, OR 97225
Phone (503) 292-9737

5050 NE Hoyt St
Ste 422
Portland, OR 97213
Phone (503) 236-4343

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

Interoperability endpoints

  • Direct secure messaging: hfichadia536383@oc.providencedirect.org

Organizations & group practices 6

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 4

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": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1245406784",
    "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": "9155 SW BARNES RD STE 532",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256632",
            "telephone_number": "503-488-2344",
            "fax_number": "503-488-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICHADIA",
        "first_name": "HETAL",
        "middle_name": "KUMUDCHANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-05",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "OR",
            "license": "MD170906",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OR",
            "license": "MD170906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2026298",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500654757",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referringpsd@1243.direct.myezyaccess.com",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "9155 SW Barnes Rd Ste 532",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.