Active NPI
Charles Roland D'Amato, MD
- Orthopaedic Surgery Physician
- Portland, OR
National Provider Identifier
1427168103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MD24651
- Practice address
- 3101 SW Sam Jackson Park Road
Portland, OR 97239-3009 - Phone
- (503) 221-3424
- Fax
- (503) 221-3490
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD24651 | OR | Primary |
Addresses
Primary practice location
3101 SW Sam Jackson Park Road
Portland, OR 97239-3009
Mailing address
PO Box 8500, Lockbox 7642
Shriners Hospital for Children Portland
Philadelphia, PA 19178-7642
Phone (813) 281-8115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227022 | Medicaid | OR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD24651 | OR | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353024000000",
"number": "1427168103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8500, LOCKBOX 7642",
"address_2": "SHRINERS HOSPITAL FOR CHILDREN PORTLAND",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191787642",
"telephone_number": "813-281-8115",
"fax_number": "813-281-8656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 SW SAM JACKSON PARK ROAD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393009",
"telephone_number": "503-221-3424",
"fax_number": "503-221-3490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'AMATO",
"first_name": "CHARLES",
"middle_name": "ROLAND",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2012-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "OR",
"license": "MD24651",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "227022",
"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 Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.