NPIMap

Individual provider Active NPI

Clarice Camposano Calopiz, M.D.

  • Family Medicine Physician
  • Hillsboro, OR
National Provider Identifier
1316051410
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD177448 Issued in OR
Practice address
5555 NE Elam Young Pkwy
Hillsboro, OR 97124-6452
Phone
(503) 216-1600
NPI assigned
Aug 18, 2006
Last updated
Oct 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A92245 CA
Family Medicine Physician 207Q00000X MD177448 OR Primary

Addresses

Primary practice location

5555 NE Elam Young Pkwy
Hillsboro, OR 97124-6452

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

1213 Eaton Ave
Suite 6
San Carlos, CA 94070-5233
Phone (650) 593-7861

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccalopiz630921@oc.providencedirect.org

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
I20160815000666 OR Practitioner - Family Practice 6800828518 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5555 NE Elam Young Pkwy
Hillsboro, OR 97124-6452
Phone (503) 216-1600

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-2213

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A92245CAMDFamily Medicine Physician
MD177448ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Family Medicine Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Aug 15, 2016 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 15, 2016 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 15, 2016 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 15, 2016 Accepting new patients
Providence Health & Services - Oregon Family Medicine Past Accepting new patients

Locations

5555 NE Elam Young Pkwy
Hillsboro, OR 97124
Phone (503) 216-1600

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

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

Interoperability endpoints

  • Direct secure messaging: ccalopiz630921@oc.providencedirect.org

Organizations & group practices 7

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1316051410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 NE ELAM YOUNG PKWY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971246452",
            "telephone_number": "503-216-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1213 Eaton Ave",
            "address_2": "Suite 6",
            "address_purpose": "LOCATION",
            "city": "San Carlos",
            "state": "CA",
            "postal_code": "940705233",
            "country_code": "US",
            "telephone_number": "650-593-7861",
            "fax_number": "650-593-6144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALOPIZ",
        "first_name": "CLARICE",
        "middle_name": "CAMPOSANO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A92245",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD177448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccalopiz630921@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5555 NE Elam Young Pkwy",
            "city": "Hillsboro",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971246452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.