Individual provider Active NPI

Maria Dulce Regina Tomas Zarraga, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Portland, OR
National Provider Identifier
1386835981
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD150677 Issued in OR
Practice address
2222 NW Lovejoy St
Suite 315
Portland, OR 97210
Phone
(503) 413-8018
Fax
(503) 413-8011
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD150677 OR Primary

Addresses

Primary practice location

2222 NW Lovejoy St
Suite 315
Portland, OR 97210

Mailing address

2222 NW Lovejoy St
Suite 315
Portland, OR 97210
Phone (503) 413-8018

Other identifiers 1

IdentifierTypeStateIssuer
218105MedicaidOR

Other names 1

  • Maria Dulce Regina Velasco Tomas Former name

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
I20101213000397 OR Practitioner - Geriatric MedicinePractitioner - Internal Medicine 8022205376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074

6485 SW Borland Rd
Suite F
Tualatin, OR 97062-9762
Phone (503) 413-8018

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Nov 16, 2015 Accepting new patients
Legacy Clinics LLC CurrentSince Nov 16, 2015 Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

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

2222 NW Lovejoy St
Ste 315
Portland, OR 97210
Phone (503) 226-6321

Interoperability endpoints

  • Direct secure messaging: mtomas72788@direct.lhs.org

Organizations & group practices 2

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1386835981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST",
            "address_2": "SUITE 315",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-413-8018",
            "fax_number": "503-413-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST",
            "address_2": "SUITE 315",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-413-8018",
            "fax_number": "503-413-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZARRAGA",
        "first_name": "MARIA DULCE REGINA",
        "middle_name": "TOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OR",
            "license": "MD150677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218105",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA DULCE REGINA",
            "last_name": "TOMAS",
            "middle_name": "VELASCO",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.