Internal Medicine of Oregon, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD15289 Issued in OR

Legal business name

INTERNAL MEDICINE OF OREGON, LLC

Practice address

5050 NE Hoyt St
Suite 203
Portland, OR 97213-2991

Phone

(503) 230-9224

Fax

(503) 230-9201

NPI assigned

Sep 24, 2007

Last updated

Nov 26, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Porfirio Pena Jr., MDNPI 1255496709

Title

Owner

Phone

(503) 230-9224

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Porfirio Pena Jr., M.D.

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1255496709
  Medicare reassignment Authorized official
• Gabriel Joseph Francetich, PA-C

  • Physician Assistant
  • Portland, OR
  • NPI 1710497185

  Internal Medicine

  NPD
• Antonio Pena, MD

  • Specialist
  • Portland, OR
  • NPI 1760531115

  Internal Medicine

  NPD
• William A Spisak, M.D.

  • Specialist
  • Portland, OR
  • NPI 1740274554
  NPD
• Jeffrey J Horacek, MD

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1790721215
  NPD (past)

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1538355417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "SUITE 203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132991",
            "telephone_number": "503-230-9224",
            "fax_number": "503-230-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "SUITE 203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132991",
            "telephone_number": "503-230-9224",
            "fax_number": "503-230-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF OREGON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "PORFIRIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-230-9224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD15289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000810",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Integrity Health Incorporated
• Intercultual Psychiatric Progam
• Interim Healthcare of Oregon, Inc.
• Internal Medicine Associates of Portland, LLC
• Internal Medicine Consultants, P.C.
• Internal Medicine Specialists, LLC
• Interpersonal Growth Organization, LLC
• Interstate Medical Group LLC
• Onedonna Inthavong, LMT
• C. Maria Intrieri, DC

• 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 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.