Individual provider Active NPI

Philip T Alexander, MD

  • Vascular Surgery Physician
  • Portland, OR
National Provider Identifier
1386640688
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
13648 Issued in OR
Practice address
9701 SW Barnes Rd
Ste 140
Portland, OR 97225
Phone
(503) 292-9565
Fax
(503) 292-9478
NPI assigned
Jun 22, 2005
Last updated
Mar 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 13648 OR Primary

Addresses

Primary practice location

9701 SW Barnes Rd
Ste 140
Portland, OR 97225

Mailing address

9701 SW Barnes Rd #140
Portland, OR 97225-9149
Phone (503) 292-9565

Other identifiers 1

IdentifierTypeStateIssuer
000229MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13648ORMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1386640688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 SW BARNES RD #140",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972259149",
            "telephone_number": "503-292-9565",
            "fax_number": "503-292-9478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 SW BARNES RD",
            "address_2": "STE 140",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-292-9565",
            "fax_number": "503-292-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "PHILIP",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OR",
            "license": "13648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000229",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.