Active NPI
Michael Ptak
- Registered Nurse
- Hillsboro, OR
National Provider Identifier
1316400237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 201900293RN
- Practice address
- 10690 NE Cornell Rd Ste 220
Hillsboro, OR 97124-9224 - Phone
- (503) 848-5861
- NPI assigned
- Apr 8, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 201900293RN | OR | Primary |
Addresses
Primary practice location
10690 NE Cornell Rd Ste 220
Hillsboro, OR 97124-9224
Mailing address
6420 SW Macadam Ave Ste 300
Portland, OR 97239-3519
Phone (503) 941-3077
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201900293RN | OR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554681600000",
"number": "1316400237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6420 SW MACADAM AVE STE 300",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393519",
"telephone_number": "503-941-3077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10690 NE CORNELL RD STE 220",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971249224",
"telephone_number": "503-848-5861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PTAK",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-08",
"last_updated": "2019-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "201900293RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
- Providence Health & Services - Oregon (Providence Medical Group)
- Providence Health & Services - Oregon (Providence Medical Group)
- Providence Health & Services Oregon (Providence Medical Group)
- PT En Route, LLC
- PT Physical Therapy, Inc
- Brianne Puckett, LMT
- Debra Lynn Pugh, PMHNP-BC
- Elizabeth Pugsley, LPC
- Ronda L Pulse II, MD
- Aman Punjani
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.