Individual provider Active NPI

Khashayar Farsad, M.D.

  • Vascular & Interventional Radiology Physician
  • Portland, OR
National Provider Identifier
1376578609
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD153946 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd # L-605
Portland, OR 97239-3011
Phone
(503) 494-7660
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 227646 MA
Vascular & Interventional Radiology Physician 2085R0204X 227646 MA
Vascular & Interventional Radiology Physician 2085R0204X MD153946 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd # L-605
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd # L-605
Portland, OR 97239-3011
Phone (503) 494-7660

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
I20110810000191 OR Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8224169313 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Yale University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Salem Hospital Hospital, Salem, OR, CCN 380051

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227646MAMDDiagnostic Radiology Physician
MD153946ORMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince Jan 1, 2021 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jan 1, 2021 Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Jan 1, 2021 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Jan 1, 2021 Accepting new patients
University Professional Services CurrentSince Aug 11, 2011 Accepting new patients
University Professional Services Current Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jan 1, 2021 Accepting new patients
Legacy Mount Hood Medical Center Current Accepting new patients
University Professional Services CurrentSince Aug 11, 2011 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Oregon Health & Science University Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

3181 SW Sam Jackson Park Rd
#L605
Portland, OR 97239
Phone (503) 494-2265

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

Interoperability endpoints

  • Direct secure messaging: kfarsadmd73737@direct.ohsu.edu

Organizations & group practices 12

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 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1376578609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # L-605",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # L-605",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARSAD",
        "first_name": "KHASHAYAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "227646",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MA",
            "license": "227646",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OR",
            "license": "MD153946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.