Active NPI
John McAnulty
- Cardiovascular Disease Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MD09170
- Practice address
- 1040 NW 22ND Ave, Suite 660
Portland, OR 97210 - Phone
- (503) 413-7162
- Fax
- (503) 413-7148
- NPI assigned
- Jun 23, 2006
- Last updated
- Jun 10, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD09170 | OR | |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 9170 | OR | |
| Cardiovascular Disease Physician | 207RC0000X | MD09170 | OR | Primary |
Addresses
Primary practice location
1040 NW 22ND Ave, Suite 660
Portland, OR 97210
Mailing address
PO Box 3777
Portland, OR 97208-3777
Phone (503) 413-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125849 | Medicaid | OR |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Tufts University School of Medicine, 1969
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711
1015 Nw22Nd Ave
Suite 34
Portland, OR 97210-3025
Phone (503) 413-6376
1040 NW 22ND Ave
Suite 630
Portland, OR 97210-3041
Phone (503) 413-7162
1040 NW 22ND Ave
Suite 660
Portland, OR 97210-3083
Phone (503) 413-7162
1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988
1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074
2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-1122
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.62 of 100
- Quality
- 77.21
- Promoting interoperability
- 99.06
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD09170 | OR | MD | Internal Medicine Physician |
| 9170 | OR | MD | Clinical Cardiac Electrophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Good Samaritan Hospital and Medical Center | Current | Accepting new patients | |
| Legacy Good Samaritan Hospital and Medical Center | Current | Accepting new patients | |
| Legacy Good Samaritan Hospital and Medical Center | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Good Samaritan Hospital and Medical Center | Past | Accepting new patients | |
| Legacy Clinics LLC | Past | Accepting new patients | |
| Firstcare Medical Foundation | Internal Medicine | Past | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
1040 NW 22nd Ave
Ste 630
Portland, OR 97210
Phone (503) 796-2743
1040 NW 22nd Ave
Ste 660
Portland, OR 97210
Phone (503) 692-0405
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
1130 NW 22nd Ave
Ste 400
Portland, OR 97210
Phone (503) 413-6555
1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074
1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
501 N Graham St
Ste 220
Portland, OR 97227
Phone (503) 413-4710
Interoperability endpoints
- jmcanulty2912@direct.lhs.org
Organizations & group practices 9
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.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1780608216
-
- Clinic/Center
- Portland, OR
- NPI 1902827272
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
dba Apothecary at Emanuel Hospital
- Community/Retail Pharmacy
- Portland, OR
- NPI 1417977976
-
- Community/Retail Pharmacy
- Portland, OR
- NPI 1609896174
-
dba Legacy Good Samaritan Providers
- Clinic/Center
- Portland, OR
- NPI 1679597108
-
dba Samaritan Medical Clinics
- Family Medicine Physician
- Albany, OR
- NPI 1740216498
Internal Medicine
-
dba Legacy Medical Group Firwood
- Rural Health Clinic/Center
- Sandy, OR
- NPI 1730472192
-
- Psychiatric Hospital Unit
- Portland, OR
- NPI 1336162874
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Unity Center for Behavioral Health-PES
- General Acute Care Hospital
- Portland, OR
- NPI 1003367491
-
dba Legacy Laboratory Services
- Clinical Medical Laboratory
- Portland, OR
- NPI 1295756898
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
dba Legacy Good Samaritan Providers
- Clinic/Center
- Portland, OR
- NPI 1679597108
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1780608216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560124800000",
"number": "1518993492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3777",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083777",
"telephone_number": "503-413-3900",
"fax_number": "503-413-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 NW 22ND AVE, SUITE 660",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97210",
"telephone_number": "503-413-7162",
"fax_number": "503-413-7148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCANULTY",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-23",
"last_updated": "2019-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD09170",
"primary": false
},
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "OR",
"license": "9170",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "OR",
"license": "MD09170",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "125849",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.