Individual provider Active NPI

Alvin K Nakamura, M.D.

  • Obstetrics & Gynecology Physician
  • Portland, OR
National Provider Identifier
1528029345
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD17656 Issued in OR
Practice address
10000 SE Main St
Suite 248
Portland, OR 97216-2448
Phone
(503) 257-7757
Fax
(503) 257-6703
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD17656 OR Primary

Addresses

Primary practice location

10000 SE Main St
Suite 248
Portland, OR 97216-2448

Mailing address

10000 SE Main St
Suite 248
Portland, OR 97216-2448
Phone (503) 257-7757

Other identifiers 2

IdentifierTypeStateIssuer
044995MedicaidOR
R00WFBCLCOtherORPTAN

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
I20100923001426 OR Practitioner - Obstetrics/Gynecology 3779634712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loma Linda University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Columbia Medical CenterGroup PAC ID 3779487251, shared by 6 NPIs, 99 clinicians

Practice addresses (Care Compare)

10000 SE Main St
Suite 248
Portland, OR 97216-2469
Phone (503) 257-7757

1810 E 19TH St
The Dalles, OR 97058-3388

Hospital & facility affiliations

  • Adventist Health Portland Hospital, Portland, OR, CCN 380060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD17656ORMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgetown Medical Group P.C. Obstetrics & Gynecology Current Accepting new patients
Bridgetown Medical Group P.C. Obstetrics & Gynecology CurrentSince Mar 1, 1995 Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients

Locations

10000 SE Main St
Ste 248
Portland, OR 97216
Phone (503) 257-7757

Interoperability endpoints

  • Direct secure messaging: bridgetownwomenscare.alvinnakamura@137210.advancedmd-direct.com
  • Direct secure messaging: anakamura154678@direct.ohsu.edu

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 and National Provider Directory roles.

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1528029345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST",
            "address_2": "SUITE 248",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162448",
            "telephone_number": "503-257-7757",
            "fax_number": "503-257-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST",
            "address_2": "SUITE 248",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162448",
            "telephone_number": "503-257-7757",
            "fax_number": "503-257-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "ALVIN",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD17656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044995",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "R00WFBCLC",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.