Individual provider Active NPI

Nick Orem Esmonde I, MD, MPH

  • Plastic Surgery Physician
  • Portland, OR
National Provider Identifier
1477973386
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD198692 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
L579
Portland, OR 97239-3011
Phone
(503) 494-8652
Fax
(503) 494-8513
NPI assigned
Apr 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD198692 OR Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
L579
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
L579
Portland, OR 97239-3011
Phone (503) 494-8652

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
I20230320001182 OR Practitioner - Plastic and Reconstructive Surgery 4688891575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Oregon Health Sciences University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 630
Portland, OR 97210-2977
Phone (503) 413-6160

Merit-based Incentive Payment System (MIPS)

Final score
92.34 of 100Reported as group
Quality
92.55
Promoting interoperability
100
Improvement activities
40
Cost
76.53

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD198692ORMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Good Samaritan Hospital and Medical Center Psychiatry CurrentSince Feb 27, 2023 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Feb 27, 2023 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
The Meltzer Clinic Plastic Surgery Past Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Past Accepting new patients

Locations

1130 NW 22nd Ave
Ste 630
Portland, OR 97210
Phone (503) 228-8469

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2222 NW Lovejoy St
Ste 606
Portland, OR 97210
Phone (503) 229-7554

Organizations & group practices 5

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1477973386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "L579",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8652",
            "fax_number": "503-494-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "L579",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8652",
            "fax_number": "503-494-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESMONDE",
        "first_name": "NICK",
        "middle_name": "OREM",
        "name_suffix": "I",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OR",
            "license": "MD198692",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.