Organization Active NPI

Paul M Puziss MD PC

  • Orthopaedic Surgery Physician
  • Beaverton, OR
National Provider Identifier
1477566974
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
11897 Issued in OR
Legal business name
PAUL M PUZISS MD PC
Practice address
3800 SW Cedar Hills Blvd
Suite 250
Beaverton, OR 97005-4760
Phone
(503) 646-8995
Fax
(503) 644-4678
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paul M Puziss, MDNPI 1023291374
Title
President
Phone
(503) 646-8995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 11897 OR Primary

Addresses

Primary practice location

3800 SW Cedar Hills Blvd
Suite 250
Beaverton, OR 97005-4760

Mailing address

3800 SW Cedar Hills Blvd
Suite 250
Beaverton, OR 97005-4760
Phone (503) 646-8995

Other identifiers 1

IdentifierTypeStateIssuer
05841ZMedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210325002587 OR Part B Supplier - Clinic/Group Practice 5799192357 Receives reassigned benefits from 1 practitioner
Practice locations: Beaverton, OR

National Provider Directory

National Provider Directory

Locations

3800 SW Cedar Hills Blvd
Ste 250
Beaverton, OR 97005
Phone (503) 526-8814

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477566974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SW CEDAR HILLS BLVD",
            "address_2": "SUITE 250",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054760",
            "telephone_number": "503-646-8995",
            "fax_number": "503-644-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SW CEDAR HILLS BLVD",
            "address_2": "SUITE 250",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054760",
            "telephone_number": "503-646-8995",
            "fax_number": "503-644-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL M PUZISS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PUZISS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-646-8995",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "11897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05841Z",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.