Individual provider Active NPI

Sanjay Krishnaswami, MD

  • Pediatric Surgery Physician
  • Portland, OR
National Provider Identifier
1427063924
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
MD26233 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-7764
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X MD26233 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

408 NW 12TH Ave Apt 302
Portland, OR 97209-2945

Other identifiers 1

IdentifierTypeStateIssuer
276328MedicaidOR

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
I20051128000244 OR Practitioner - Pediatric MedicinePractitioner - General Surgery 6709806441 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tuality Medical Group LLC CurrentSince Jul 16, 2020 Accepting new patients
University Professional Services CurrentSince Jul 18, 2010 Accepting new patients
Tuality Medical Group LLC CurrentSince Jul 16, 2020 Accepting new patients
University Professional Services Current Accepting new patients
Oregon Health & Science University Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients
University Professional Services Past Accepting new patients
Legacy Emanuel Hospital & Health Center Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

333 SE 7th Ave
Ste 5200
Hillsboro, OR 97123
Phone (503) 640-5737

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

501 N Graham St
Ste 300
Portland, OR 97227
Phone (503) 413-4300

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

875 Oak St SE
Salem, OR 97301
Phone (503) 561-5719

Interoperability endpoints

  • Direct secure messaging: skrishnaswamimd12895@direct.ohsu.edu

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427063924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 NW 12TH AVE APT 302",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNASWAMI",
        "first_name": "SANJAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "OR",
            "license": "MD26233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276328",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.