Individual provider Active NPI

Angela Tay Zimmerman, MD

  • Pediatric Anesthesiology Physician
  • Portland, OR
National Provider Identifier
1457396038
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
MD21908 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Uhs-2
Portland, OR 97239-3011
Phone
(503) 494-4910
Fax
(503) 494-8368
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD21908 OR
Pediatric Anesthesiology Physician 207LP3000X MD21908 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Uhs-2
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Uhs-2
Portland, OR 97239-3011
Phone (503) 494-4910

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
I20100106000538 OR Practitioner - Anesthesiology 0143361675 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Cincinnati College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesiology Associates LLCGroup PAC ID 6901702869, 239 clinicians

Practice addresses (Care Compare)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-7641

3181 Swsam Jackson Park Rd
Portland, OR 97239-3011

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
98.65
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00000ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Dec 1, 2010 Accepting new patients
University Professional Services Current Accepting new patients
University Anesthesiology Associates, LLC Anesthesiology CurrentSince Nov 19, 2009 Accepting new patients
University Professional Services CurrentSince Dec 1, 2010 Accepting new patients

Locations

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

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

3181 SW Sam Jackson Park Rd
#2
Portland, OR 97239
Phone (503) 494-4910

Interoperability endpoints

  • Direct secure messaging: azimmerman24033@direct.ohsu.edu

Organizations & group practices 4

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1457396038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "UHS-2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "UHS-2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-4910",
            "fax_number": "503-494-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "ANGELA",
        "middle_name": "TAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD21908",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "OR",
            "license": "MD21908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.