Individual provider Active NPI

Nikolas A. Jones, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Portland, OR
National Provider Identifier
1417997107
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
MD25684 Issued in OR
Practice address
2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone
(503) 413-4121
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X MD25684 OR Primary

Addresses

Primary practice location

2801 N Gantenbein Ave
Portland, OR 97227-1623

Mailing address

1509 SW Capitol Hwy
#502
Portland, OR 97239-2690
Phone (503) 464-9034

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address njones780534@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060706000232 OR Practitioner - Emergency Medicine 1850303066 Reassigns benefits to 4 organizations
I20200409003906 WA Practitioner - Emergency Medicine 1850303066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95 of 100Reported as group
Quality
83.34
Promoting interoperability
100
Improvement activities
40
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25684ORMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Coos Health District CurrentSince Nov 21, 2013 Accepting new patients
Western Healthcare Services Texas CurrentSince Apr 1, 2023 Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 1, 2017 Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 1, 2017 Accepting new patients
Northwest Acute Care Specialists PC CurrentSince Aug 1, 2006 Accepting new patients
Southern Coos Health District CurrentSince Nov 21, 2013 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Northwest Acute Care Specialists PC CurrentSince Aug 1, 2006 Accepting new patients

Locations

900 11th St SE
Bandon, OR 97411
Phone (541) 237-2426

500 5th St
Brookings, OR 97415
Phone (541) 412-2000

94220 4th St
Gold Beach, OR 97444
Phone (541) 247-3000

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

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

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Interoperability endpoints

  • Direct secure messaging: njones780534@oc.providencedirect.org

Organizations & group practices 8

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1417997107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 SW CAPITOL HWY",
            "address_2": "#502",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392690",
            "telephone_number": "503-464-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 N GANTENBEIN AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271623",
            "telephone_number": "503-413-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "NIKOLAS",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OR",
            "license": "MD25684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "njones780534@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "810 12th St",
            "city": "Hood River",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970311587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.