Individual provider Active NPI

Zachary Paul Krush, DNP, FNP-C

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1548986318
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11806986-3102 Issued in UT
Practice address
3653 SE 34TH Ave
Portland, OR 97202-3034
Phone
(503) 988-5140
NPI assigned
Oct 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11806986-3102 UT Primary

Addresses

Primary practice location

3653 SE 34TH Ave
Portland, OR 97202-3034

Mailing address

4538 NE Failing St
Portland, OR 97213-1058
Phone (701) 516-2065

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221117001950 OR Practitioner - Nurse Practitioner 6709254022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multnomah CountyGroup PAC ID 6608771787, 111 clinicians

Practice addresses (Care Compare)

12710 SE Division
Mid County Health Center
Portland, OR 97236-3134
Phone (503) 988-3601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11806986-3102UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Oct 18, 2022 Accepting new patients
Multnomah County Current Accepting new patients
Mulnomah County CurrentSince Oct 18, 2022 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674

12710 SE Division St
Portland, OR 97236
Phone (503) 988-3410

3653 SE 34th Ave
Portland, OR 97202
Phone (503) 988-3506

Interoperability endpoints

  • Direct secure messaging: zkrush602573@direct.ochin.org

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 5

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": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1548986318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4538 NE FAILING ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131058",
            "telephone_number": "701-516-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3653 SE 34TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023034",
            "telephone_number": "503-988-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSH",
        "first_name": "ZACHARY",
        "middle_name": "PAUL",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11806986-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.