Individual provider Active NPI

Ami Kapadia, M.D.

  • Family Medicine Physician
  • Vancouver, WA
National Provider Identifier
1366565509
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD 153491 Issued in OR
Practice address
11719 NE 95TH St Ste a/D
Vancouver, WA 98682-2444
Phone
(360) 397-8246
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD433101 PA
Family Medicine Physician 207Q00000X MD.MD.61420145 WA
Family Medicine Physician 207Q00000X MD 153491 OR Primary

Addresses

Primary practice location

11719 NE 95TH St Ste a/D
Vancouver, WA 98682-2444

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other practice location 1

1321 NE 99th Ave
Suite 100
Portland, OR 97220-9436
Phone (503) 215-9900

Other identifiers 4

IdentifierTypeStateIssuer
500637214MedicaidOR
P00983321OtherORRR MEDICARE - PH&S
0171948MedicaidNJ
1021982730001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address akapadia103959@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20111012000561 OR Practitioner - Family Practice 2961579909 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 153491ORMDFamily Medicine Physician
MD.MD.61420145WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Jan 7, 2014 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 7, 2014 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1366565509",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11719 NE 95TH ST STE A/D",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986822444",
            "telephone_number": "360-397-8246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 NE 99th Ave",
            "address_2": "SUITE 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972209436",
            "country_code": "US",
            "telephone_number": "503-215-9900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAPADIA",
        "first_name": "AMI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD433101",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD.MD.61420145",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD 153491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500637214",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE - PH&S",
            "identifier": "P00983321",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0171948",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021982730001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akapadia103959@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "18610 NW Cornell Rd Ste 101",
            "city": "Hillsboro",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971249206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.