Active NPI
Bariisaa Kedir Sultan
- Contractor
- Portland, OR
National Provider Identifier
1538054366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 2110 SE 82ND Ave
Portland, OR 97216-1410 - Phone
- (971) 254-8916
- NPI assigned
- Jun 11, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
2110 SE 82ND Ave
Portland, OR 97216-1410
Mailing address
14021 E Burnside St
Portland, OR 97233-2131
Phone (503) 583-6204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749600000000",
"number": "1538054366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14021 E BURNSIDE ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972332131",
"telephone_number": "503-583-6204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2110 SE 82ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972161410",
"telephone_number": "971-254-8916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULTAN",
"first_name": "BARIISAA",
"middle_name": "KEDIR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-06-11",
"last_updated": "2025-06-11",
"certification_date": "2025-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.