Individual provider Active NPI

Hari Dass Singh Khalsa, D.C.

  • Chiropractor
  • Portland, OR
National Provider Identifier
1356348650
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1809 Issued in OR
Practice address
5013 SE Hawthorne Blvd
Portland, OR 97215-3255
Phone
(503) 238-1032
Fax
(503) 233-1916
NPI assigned
Jun 30, 2005
Last updated
Feb 3, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1809 OR Primary

Addresses

Primary practice location

5013 SE Hawthorne Blvd
Portland, OR 97215-3255

Mailing address

5013 SE Hawthorne Blvd
Portland, OR 97215-3255
Phone (503) 238-1032

Other identifiers 6

IdentifierTypeStateIssuer
0004568715OtherORAETNA
370078OtherORAMERICAN SPECIALTY HEALTH
026824000OtherORREGENCE BCBS OF OR
000000005009OtherORHEALTH FUTURE / NCSD
J2037OtherORPACIFIC SOURCE
3530716OtherORCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090313000440 OR Practitioner - Chiropractic 7214094408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5013 SE Hawthorne Blvd
Portland, OR 97215-3255
Phone (503) 238-1032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1809ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Khalsa Pain Relief Clinic, P.C. Chiropractor CurrentSince Oct 1, 1982 Accepting new patients

Locations

5013 SE Hawthorne Blvd
Portland, OR 97215
Phone (503) 238-1032

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1356348650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5013 SE HAWTHORNE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153255",
            "telephone_number": "503-238-1032",
            "fax_number": "503-233-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5013 SE HAWTHORNE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153255",
            "telephone_number": "503-238-1032",
            "fax_number": "503-233-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALSA",
        "first_name": "HARI DASS",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "1809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004568715",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECIALTY HEALTH",
            "identifier": "370078",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BCBS OF OR",
            "identifier": "026824000",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH FUTURE / NCSD",
            "identifier": "000000005009",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC SOURCE",
            "identifier": "J2037",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3530716",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.