Andris Antoniskis, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD10115 Issued in OR

Practice address

5228 NE Hoyt St
BLDG B, 3Rd Floor
Portland, OR 97213-3055

Phone

(503) 215-2584

Fax

(503) 215-1524

NPI assigned

Jul 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Thomas a Firth MD PC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1255590600
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1528067972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5228 NE HOYT ST",
            "address_2": "BLDG B, 3RD FLOOR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133055",
            "telephone_number": "503-215-2584",
            "fax_number": "503-215-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONISKIS",
        "first_name": "ANDRIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD10115",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OR",
            "license": "MD10115",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220376",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500626738",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madelyn Antinucci, LCSW
• Kylie Antolini, RDH
• Cory Anton
• Joe Antone, LMT
• Armani Antonellis, LMT
• Diana Antoniskis, M.D.
• Melissa Rose Antonowicz
• Lindsay Antonsen
• Matthew Graham Antony, D.D.S.
• Megan Antosik, MS, RD, LD

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.