Individual provider Active NPI

Andrea Loran Matsumura, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1487761136
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD22819 Issued in OR
Practice address
3036 NE MLK Jr Blvd
Portland, OR 97212-3053
Phone
(503) 283-3763
NPI assigned
Aug 25, 2006
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X MD22819 OR
Internal Medicine Physician 207R00000X MD22819 OR Primary

Addresses

Primary practice location

3036 NE MLK Jr Blvd
Portland, OR 97212-3053

Mailing address

PO Box 8459
Portland, OR 97207-8459
Phone (503) 238-0769

Other practice location 1

10373 NE Hancock St Ste 125
Portland, OR 97220-3873
Phone (503) 253-6754

Other practice location 2

4212 SE Division St Ste 100
Portland, OR 97206-1680
Phone (503) 238-0705

Other practice location 3

12360 SE Sunnyside Rd
Clackamas, OR 97015-9320
Phone (503) 303-4000

Other names 1

  • Ms. Andrea Loran Navarijo Former name

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
I20071218000050 OR Practitioner - Internal Medicine 5799875522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cascadia HealthGroup PAC ID 7618873761, 53 clinicians

Practice addresses (Care Compare)

847 NE 19TH Ave
Suite 100
Portland, OR 97232-2684
Phone (502) 238-0769

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cascadia Health CurrentSince Sep 9, 2024 Accepting new patients
Cascadia Health CurrentSince Sep 9, 2024 Accepting new patients
Cascadia Health Past Accepting new patients

Locations

12360 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 303-4000

10373 NE Hancock St
Ste 125
Portland, OR 97220
Phone (503) 253-6754

3036 NE Mlk Jr Blvd
Portland, OR 97212
Phone (503) 283-3763

4212 SE Division St
Ste 100
Portland, OR 97206
Phone (503) 238-0705

707 NW Everett St
Portland, OR 97209
Phone (503) 222-4906

847 NE 19th Ave
Ste 100
Portland, OR 97232
Phone (503) 552-6203

847 NE 19th Ave
Ste 300
Portland, OR 97232

Interoperability endpoints

  • Direct secure messaging: amatsumura736254@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1487761136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3036 NE MLK JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123053",
            "telephone_number": "503-283-3763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10373 NE Hancock St Ste 125",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972203873",
            "country_code": "US",
            "telephone_number": "503-253-6754",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4212 SE Division St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972061680",
            "country_code": "US",
            "telephone_number": "503-238-0705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12360 SE Sunnyside Rd",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970159320",
            "country_code": "US",
            "telephone_number": "503-303-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATSUMURA",
        "first_name": "ANDREA",
        "middle_name": "LORAN",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "OR",
            "license": "MD22819",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD22819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "NAVARIJO",
            "middle_name": "LORAN",
            "prefix": "MS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.