Individual provider Active NPI

David Fillmore, MD

  • Diagnostic Radiology Physician
  • Portland, OR
National Provider Identifier
1255315057
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD224202 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-3918
NPI assigned
Dec 5, 2005
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD2008-0074 NM
Vascular & Interventional Radiology Physician 2085R0204X MD2008-0074 NM
Diagnostic Radiology Physician 2085R0202X MD224202 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-3918

Other identifiers 1

IdentifierTypeStateIssuer
000E7354MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20080501000081 NM Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 6901893825 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Yale University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Otero County Hospital AssociationGroup PAC ID 3173516606, 245 clinicians
New Mexico Oncology Hematology Consultants LTDGroup PAC ID 3577533447, 66 clinicians
X-Ray Associates of New Mexico PCGroup PAC ID 6709879430, 53 clinicians

Practice addresses (Care Compare)

2669 Scenic Dr
Alamogordo, NM 88310-8700
Phone (505) 439-6100

4901 Lang Ave NE
New Mexico Cancer Center
Albuquerque, NM 87109-4397
Phone (505) 842-8171

8020 Constitution PL NE
Suite 101
Albuquerque, NM 87110-7638
Phone (505) 998-1317

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15501AZMDPharmacist
19724OKMDPharmacist
19727OKMDPharmacist
MD2008-0074NMMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
X-Ray Associates of New Mexico PC Diagnostic Radiology CurrentSince May 1, 2008 Accepting new patients
Imaging Associates of New Mexico LLC Diagnostic Radiology CurrentSince Mar 16, 2024 Accepting new patients
Cibola General Hospital Corporation CurrentSince Aug 1, 2024 Accepting new patients
KND Development 59, LLC CurrentSince Jan 1, 2012 Accepting new patients
New Mexico Oncology Hematology Consultants, LTD. CurrentSince Nov 1, 2022 Accepting new patients
Otero County Hospital Association CurrentSince Jan 1, 2024 Accepting new patients
Otero County Hospital Association CurrentSince Jan 1, 2024 Accepting new patients
KND Development 59 LLC CurrentSince Jan 1, 2012 Accepting new patients
Portland Medical Imaging LLC Diagnostic Radiology Past Accepting new patients
Radiology Specialists of the Northwest, PC Diagnostic Radiology PastSince Aug 1, 2015 Accepting new patients
University Radiology Associates Diagnostic Radiology Past Accepting new patients
Madison Medical LLC PastSince May 1, 2021 Accepting new patients
The Oregon Clinic, PC Past Accepting new patients

Locations

2539 Medical Dr
Ste 101
Alamogordo, NM 88310
Phone (505) 434-1353

2669 Scenic Dr
Alamogordo, NM 88310
Phone (505) 439-6100

10200 Corrales Rd NW
Ste B4
Albuquerque, NM 87114

8020 Constitution Pl NE
Ste 101
Albuquerque, NM 87110
Phone (505) 998-1317

8020 Constitution Pl NE
Ste 202
Albuquerque, NM 87110
Phone (505) 559-5628

504 Elm St NE
Albuquerque, NM 87102
Phone (505) 724-2000

700 High St NE
Albuquerque, NM 87102
Phone (505) 242-4444

4901 Lang Ave NE
Albuquerque, NM 87109
Phone (505) 828-3877

2240 College Dr
Gallup, NM 87301
Phone (505) 297-1052

1423 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-6500

1016 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-4446

3917 West Rd
Los Alamos, NM 87544
Phone (505) 661-9584

490A W Zia Rd
Santa Fe, NM 87505
Phone (505) 913-8900

4200 Beckner Rd
Santa Fe, NM 87507
Phone (505) 477-2200

Organizations & group practices 13

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.

View all 13

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1255315057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLMORE",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MD2008-0074",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NM",
            "license": "MD2008-0074",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD224202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E7354",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.