Individual provider Active NPI

Claudine Y Moreno, MD

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1376571646
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD21201 Issued in OR
Practice address
5050 NE Hoyt St
Suite 240
Portland, OR 97213-2991
Phone
(503) 215-6480
Fax
(503) 215-6469
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD21201 OR Primary

Addresses

Primary practice location

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2991

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
287345MedicaidOR
P00400437OtherORRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmoreno117790@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
I20041217000443 OR Practitioner - Family Practice 9133186463 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

5050 NE Hoyt St
Suite 454
Portland, OR 97213-2984
Phone (503) 215-6405

Hospital & facility affiliations

  • Providence Home Health Home health agency, Portland, OR, CCN 387048
  • Providence Hospice Hospice, Portland, OR, CCN 381500
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21201ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Family Medicine CurrentSince Oct 16, 2012 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Jul 21, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 21, 2018 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 16, 2012 Accepting new patients
Providence Health & Services - Oregon Family Medicine Past Accepting new patients

Locations

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

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

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

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

10202 SE 32nd Ave
Ste 703
Portland, OR 97222
Phone (503) 282-0943

5279 N Lombard St
Portland, OR 97203
Phone (503) 215-3300

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1376571646",
    "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",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "SUITE 240",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132991",
            "telephone_number": "503-215-6480",
            "fax_number": "503-215-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "CLAUDINE",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD21201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287345",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00400437",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmoreno117790@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St",
            "address_2": "Suite 240",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.