NPIMap

Individual provider Active NPI

Siddharth K Joshi, M.D.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1467710632
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD171657 Issued in OR
Practice address
4805 NE Glisan St
Portland, OR 97213-2933
Phone
(503) 215-2392
NPI assigned
Apr 25, 2012
Last updated
Jun 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD171657 OR Primary

Addresses

Primary practice location

4805 NE Glisan St
Portland, OR 97213-2933

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

1001 Molalla Avenue
Ste 100
Oregon City, OR 97045
Phone (718) 780-5246

Other practice location 2

3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Phone (541) 768-5111

Other identifiers 1

IdentifierTypeStateIssuer
500691282MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sjoshi556920@oc.providencedirect.org
Direct Messaging Address sjoshi238338@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, HI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151026002849 OR Practitioner - HospitalistPractitioner - Internal Medicine 9335458736 Reassigns benefits to 4 organizations
I20230313002730 HI Practitioner - Hospitalist 9335458736 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Healthcare Medical Associates IncGroup PAC ID 5294647574, 109 clinicians
Kauai Veterans Memorial HospitalGroup PAC ID 7911805114, 19 clinicians

Practice addresses (Care Compare)

1190 Waianuenue Ave
Hilo, HI 96720-2089
Phone (808) 932-3000

4643 Waimea Canyon Dr
Waimea, HI 96798
Phone (808) 338-9431

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD171657ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Apr 1, 2018 Accepting new patients
Columbia Lutheran Charities CurrentSince Sep 1, 2023 Accepting new patients
Samuel Mahelona Memorial Hospital CurrentSince Oct 30, 2024 Accepting new patients
Samuel Mahelona Memorial Hospital Current Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 1, 2018 Accepting new patients
Kauai Veterans Memorial Hospital CurrentSince Jan 12, 2026 Accepting new patients
Kauai Veterans Memorial Hospital CurrentSince Apr 1, 2023 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Jun 1, 2016 Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Jun 7, 2023 Accepting new patients
Samuel Mahelona Memorial Hospital CurrentSince Oct 30, 2024 Accepting new patients
Hawaii Post-Acute Medical Services 1 Inc CurrentSince Jun 7, 2023 Accepting new patients
Columbia Lutheran Charities CurrentSince Sep 1, 2023 Accepting new patients
Columbia Lutheran Charities Past Accepting new patients
Kauai Veterans Memorial Hospital Past Accepting new patients
Hilo Benioff Medical Center Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Locations

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

2111 Exchange St
Astoria, OR 97103
Phone (503) 325-4321

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

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

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

4805 NE Glisan St
Ste BG5
Portland, OR 97213
Phone (503) 215-2392

Interoperability endpoints

  • Direct secure messaging: sjoshi20529@hhsc.direct-ci.com
  • Direct secure messaging: sjoshi238338@samhealth.direct-ci.com
  • Direct secure messaging: sjoshi556920@oc.providencedirect.org

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1467710632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-2392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Molalla Avenue",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "97045",
            "country_code": "US",
            "telephone_number": "718-780-5246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973305472",
            "country_code": "US",
            "telephone_number": "541-768-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSHI",
        "first_name": "SIDDHARTH",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-25",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD171657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500691282",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjoshi556920@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4805 NE Glisan St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjoshi238338@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3600 NW Samaritan Dr",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973305472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.