Pavel Foksha

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

653593 Issued in OR

Practice address

4000 SE 82ND Ave
Suite 1500
Portland, OR 97266-2924

Phone

(503) 772-5333

Fax

(503) 772-5366

NPI assigned

Feb 26, 2007

Last updated

Dec 12, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Healthcare Medical Supply Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthcare Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
  • NPI 1396014064
  NPD (past) Authorized official

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1396871083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 SE 82ND AVE",
            "address_2": "SUITE 1500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662924",
            "telephone_number": "503-772-5333",
            "fax_number": "503-772-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 SE 82ND AVE",
            "address_2": "SUITE 1500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662924",
            "telephone_number": "503-772-5333",
            "fax_number": "503-772-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOKSHA",
        "first_name": "PAVEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OR",
            "license": "653593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274628",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEALTHCARE",
            "last_name": "SUPPLY",
            "middle_name": "MEDICAL",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Weraka Fogi
• Dolores L Foglio, FNP
• Mallory Fohl
• Jeffrey Eugene Foidel, CADC 2
• Robert G Fojtasek, MD
• Mary F. Folan Laucka, PHARM.D.
• John Charles Foland, DC, CCSP
• Ila Foley
• Irene Foley
• Jeffery M Foley, AGNP

• Durable Medical Equipment & Medical Supplies in Portland, OR
• Providers in Portland, OR by specialty
• Durable Medical Equipment & Medical Supplies in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.