Oregon Pediatrics NE Portland PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

OREGON PEDIATRICS NE PORTLAND PC

Practice address

5050 NE Hoyt St
Ste B55
Portland, OR 97213-2957

Phone

(503) 233-5393

Fax

(503) 659-8984

NPI assigned

Jun 21, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Rupa Kirit Shah, MD

Title

Co Owner & Medical Director

Phone

(503) 659-1694

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy Thomas Beyer, MD

  • Pediatrics Physician
  • Portland, OR
  • NPI 1376176958
  NPD (past)
• Diane Michelle Brace, FNP-BC

  • Family Nurse Practitioner
  • Oregon City, OR
  • NPI 1598427296
  NPD (past)
• Bassam George Hadeed, MD

  • Pediatrics Physician
  • Clackamas, OR
  • NPI 1457397176
  NPD (past)
• Alyssa Rachael Pace, PA-C

  • Medical Physician Assistant
  • Portland, OR
  • NPI 1275527483
  NPD (past)
• Heather Conroy Selis, PNP

  • Pediatrics Physician
  • Portland, OR
  • NPI 1679734719
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1366488090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "STE B55",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132957",
            "telephone_number": "503-233-5393",
            "fax_number": "503-659-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "STE B55",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132957",
            "telephone_number": "503-233-5393",
            "fax_number": "503-659-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON PEDIATRICS NE PORTLAND PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "RUPA",
        "authorized_official_middle_name": "KIRIT",
        "authorized_official_title_or_position": "CO OWNER & MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "503-659-1694",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287523",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oregon Medical Specialists PC
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• Oregon Outreach Inc
• Oregon Pain Clinic, LLC
• Oregon Pedorthic Services
• Oregon Pedorthic Services Inc
• Oregon Pedorthic Services, Inc.
• Oregon Physical Therapy & Sports
• Oregon Pulmonary Associates, P.C.

• Pediatrics Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.