Individual provider Active NPI

Thomas Joseph Valvano, M.D.

  • Pediatrics Physician
  • Portland, OR
National Provider Identifier
1477521847
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD126268 Issued in OR
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

Updated by the provider on Dec 9, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
036107015MedicaidIL

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
I20090928000191 OR Practitioner - Pediatric Medicine 9133159494 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-107015ILMDPediatrics Physician
036107015ILMDPediatrics Physician
49380-020WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Oct 1, 2009 Accepting new patients
University Professional Services CurrentSince Oct 1, 2009 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

  • Direct secure messaging: tvalvano20479@direct.lhs.org
  • Direct secure messaging: 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.

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": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.