Individual provider Active NPI

Anthony Santo Ladogana, M.D.

  • Internal Medicine Physician
  • Gresham, OR
National Provider Identifier
1275508418
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD24648 Issued in OR
Practice address
24800 SE Stark St
Mount Hood Hospital
Gresham, OR 97030-3378
Phone
(503) 674-1391
NPI assigned
Feb 21, 2006
Last updated
Mar 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD24648 OR Primary
Hospitalist Physician 208M00000X MD24648 OR

Addresses

Primary practice location

24800 SE Stark St
Mount Hood Hospital
Gresham, OR 97030-3378

Mailing address

24800 SE Stark St
Mount Hood Hospital
Gresham, OR 97030-3378
Phone (503) 674-1535

Other identifiers 1

IdentifierTypeStateIssuer
227476MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050927001128 OR Practitioner - Emergency Medicine 8628041480 Reassigns benefits to 1 organization
I20060912000426 WA Practitioner - Emergency Medicine 8628041480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

24800 SE Stark St
Gresham, OR 97030-3378
Phone (503) 413-8988

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital Hospitalist CurrentSince Jan 3, 2021 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Jan 3, 2021 Accepting new patients
Legacy Clinics LLC CurrentSince Aug 1, 2005 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Aug 1, 2005 Accepting new patients

Locations

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1275508418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24800 SE STARK ST",
            "address_2": "MOUNT HOOD HOSPITAL",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303378",
            "telephone_number": "503-674-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24800 SE STARK ST",
            "address_2": "MOUNT HOOD HOSPITAL",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303378",
            "telephone_number": "503-674-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADOGANA",
        "first_name": "ANTHONY",
        "middle_name": "SANTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD24648",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD24648",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227476",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.