Individual provider Active NPI

Naghmeh Moshtael, MD

  • Pediatrics Physician
  • Portland, OR
National Provider Identifier
1376635748
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD25716 Issued in OR
Practice address
3530 N Vancouver Ave Ste 400
Portland, OR 97227-1798
Phone
(503) 249-8851
Fax
(503) 282-3409
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD25716 OR Primary

Addresses

Primary practice location

3530 N Vancouver Ave Ste 400
Portland, OR 97227-1798

Mailing address

8709 SE Morrison St
Portland, OR 97216-1724
Phone (503) 282-0783

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
I20080331000047 OR Practitioner - Pediatric Medicine 0648356725 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kartini Clinic PC Pediatrics CurrentSince Jul 24, 2022 Accepting new patients
Legacy Emanuel Hospital & Health Center Pediatrics CurrentSince Jul 29, 2022 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Jul 29, 2022 Accepting new patients

Locations

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

2800 N Vancouver Ave
Ste 118
Portland, OR 97227
Phone (503) 249-8851

3530 N Vancouver Ave
Ste 400
Portland, OR 97227
Phone (503) 249-8851

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1376635748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8709 SE MORRISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972161724",
            "telephone_number": "503-282-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 N VANCOUVER AVE STE 400",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271798",
            "telephone_number": "503-249-8851",
            "fax_number": "503-282-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHTAEL",
        "first_name": "NAGHMEH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD25716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.