Individual provider Active NPI

Barzin Khalili, MD

  • Allergy & Immunology Physician
  • Portland, OR
National Provider Identifier
1487725990
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MD24359 Issued in OR
Practice address
511 SW 10TH Ave Ste 1301
Portland, OR 97205-2714
Phone
(503) 228-0155
Fax
(503) 226-8342
NPI assigned
Nov 13, 2006
Last updated
Mar 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD24359 OR Primary

Addresses

Primary practice location

511 SW 10TH Ave Ste 1301
Portland, OR 97205-2714

Mailing address

511 SW 10TH Ave Ste 1301
Portland, OR 97205-2714
Phone (503) 228-0155

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
I20040921000630 OR Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 2860460599 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barzin Khalili MD LLCGroup PAC ID 7911095443, 3 clinicians

Practice addresses (Care Compare)

511 SW 10TH Ave
Suite 1301
Portland, OR 97205-2714
Phone (503) 228-0155

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD24359ORMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jan 1, 2009 Accepting new patients
University Professional Services CurrentSince Jan 1, 2009 Accepting new patients
Allergy Clinic LLC PastSince Dec 1, 2007 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

Interoperability endpoints

  • Direct secure messaging: bkhalilimd12421@direct.ohsu.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1487725990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE STE 1301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052714",
            "telephone_number": "503-228-0155",
            "fax_number": "503-226-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE STE 1301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052714",
            "telephone_number": "503-228-0155",
            "fax_number": "503-226-8342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALILI",
        "first_name": "BARZIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "OR",
            "license": "MD24359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.