Individual provider Active NPI

Abhushan Poudyal, MD

  • Cardiovascular Disease Physician
  • Portland, OR
National Provider Identifier
1497107189
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD214819 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-8311
NPI assigned
Jul 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036148460 IL
Internal Medicine Physician 207R00000X MD214819 OR
Cardiovascular Disease Physician 207RC0000X 4301506197 MI
Interventional Cardiology Physician 207RI0011X MD214819 OR
Cardiovascular Disease Physician 207RC0000X MD214819 OR Primary

Addresses

Primary practice location

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

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NE, IA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190711001467 IL Practitioner - Internal Medicine 4385937960 Reassigns benefits to 1 organization
I20240913000814 NE Practitioner - Interventional Cardiology 4385937960 Reassigns benefits to 2 organizations
I20240916000325 IA Practitioner - Interventional Cardiology 4385937960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians
Alegent Creighton ClinicGroup PAC ID 1951210418, shared by 2 NPIs, 951 clinicians

Practice addresses (Care Compare)

555 S 70TH St
St Elizabeth Regional Med Center
Lincoln, NE 68510-2462
Phone (402) 219-8000

7500 Mercy Rd
Omaha, NE 68124-2319
Phone (402) 398-5580

800 Mercy Dr
Council Bluffs, IA 51503-3128
Phone (712) 328-5490

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036148460ILMDInternal Medicine Physician
4301506197MIMDCardiovascular Disease Physician
MD214819ORMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Internal Medicine CurrentSince Jun 21, 2019 Accepting new patients
Cook County Current Accepting new patients
Alegent Creighton Clinic CurrentSince Aug 20, 2024 Accepting new patients
Alegent Creighton Clinic Internal Medicine CurrentSince Aug 20, 2024 Accepting new patients
Cook County CurrentSince Jun 21, 2019 Accepting new patients
CHI Health Clinic Specialty, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

2771 Solution Ctr
Chicago, IL 60677

1969 W Ogden Ave
Apt 1
Chicago, IL 60612

3308 Samson Way
Bellevue, NE 68123
Phone (402) 291-3373

3515 Richmond Cir
Grand Island, NE 68803
Phone (308) 381-8636

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

7440 S 91st St
Lincoln, NE 68526
Phone (402) 489-6554

555 S 70th St
Lincoln, NE 68510
Phone (402) 219-8000

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1497107189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POUDYAL",
        "first_name": "ABHUSHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-06",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036148460",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD214819",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301506197",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OR",
            "license": "MD214819",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD214819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.