Active NPI
Thomas Joseph Valvano, M.D.
- Pediatrics Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD126268
- Practice address
- 707 SW Gaines Street
Doernbecher Children'S Hospital
Portland, OR 97239-2998 - Phone
- (503) 494-6513
- Fax
- (503) 418-5780
- NPI assigned
- Mar 10, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036107015 | IL | |
| Pediatrics Physician | 208000000X | MD126268 | OR | Primary |
| Pediatrics Physician | 208000000X | 49380-020 | WI | |
| Pediatrics Physician | 208000000X | 036-107015 | IL |
Addresses
Primary practice location
707 SW Gaines Street
Doernbecher Children'S Hospital
Portland, OR 97239-2998
Mailing address
707 SW Gaines Street, Mail Code:Cdrcp
Doernbecher Children'S Hospital, General Pediatrics
Portland, OR 97239-2998
Phone (503) 494-6513
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036107015 | Medicaid | IL |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-107015 | IL | MD | Pediatrics Physician |
| 036107015 | IL | MD | Pediatrics Physician |
| 49380-020 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | 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
707 SW Gaines St
Portland, OR 97239
Phone (503) 492-2709
Interoperability endpoints
- tvalvano20479@direct.lhs.org
- tvalvanomd36496@direct.ohsu.edu
Organizations & group practices 2
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.
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
- Pharmacy
- Beaverton, OR
- NPI 1073054714
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260316800000",
"number": "1477521847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 SW GAINES STREET, MAIL CODE:CDRCP",
"address_2": "DOERNBECHER CHILDREN'S HOSPITAL, GENERAL PEDIATRICS",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392998",
"telephone_number": "503-494-6513",
"fax_number": "503-418-5780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 SW GAINES STREET",
"address_2": "DOERNBECHER CHILDREN'S HOSPITAL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392998",
"telephone_number": "503-494-6513",
"fax_number": "503-418-5780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALVANO",
"first_name": "THOMAS",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-10",
"last_updated": "2009-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036107015",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "MD126268",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "49380-020",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036-107015",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036107015",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.