Moses Sujad Ijaz, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO195772 Issued in OR

Practice address

3036 NE MLK Jr Blvd
Portland, OR 97212-3053

Phone

(503) 283-3763

NPI assigned

Apr 13, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH, OR2 enrollments

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 2

Specialty

Psychiatry

Education

Michigan State University College of Osteopathic Medicine, 1987

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Cynthia Gulick PCGroup PAC ID 2860487279, 23 clinicians

Cascadia HealthGroup PAC ID 7618873761, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mijaz1188857@oc.providencedirect.org
• Direct secure messaging: mijaz795274@direct.ochin.org

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.

• Cascadia Health

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1336196401

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Cynthia Gulick, PC

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1467675009
  Medicare reassignment Care Compare group NPD
• Ohiohealth Corporation

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1578545273
  Medicare reassignment NPD
• Moses S Ijaz DO

  • Psychiatry Physician
  • Canton, OH
  • NPI 1588769863
  NPD (past) Authorized official
• Cascadia Health

  • Primary Care Clinic/Center
  • Portland, OR
  • NPI 1144722935
  NPD
• Ohiohealth Corporation

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Columbus, OH
  • NPI 1265627301
  NPD
• Ohiohealth Corporation

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1407292105
  NPD
• My Other Me

  • Gynecology Physician
  • Portland, OR
  • NPI 1801462080
  NPD (past)
• Orthopedic Trauma Services LTD

  • Orthopaedic Surgery Physician
  • Columbus, OH
  • NPI 1285622688
  NPD (past)
• Portage Path Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Akron, OH
  • NPI 1114492147
  NPD (past)
• Portage Path Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Akron, OH
  • NPI 1225087802
  NPD (past)

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1558325902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3036 NE MLK JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123053",
            "telephone_number": "503-283-3763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4805 NE Glisan St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972132933",
            "country_code": "US",
            "telephone_number": "503-215-4860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1299 Olentangy River Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432123135",
            "country_code": "US",
            "telephone_number": "614-566-4710",
            "fax_number": "614-566-6846",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4212 SE Division St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972061680",
            "country_code": "US",
            "telephone_number": "503-238-0705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IJAZ",
        "first_name": "MOSES",
        "middle_name": "SUJAD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34. 005207",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "DO195772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2275621",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500776126",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mijaz1188857@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4805 NE Glisan St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Valeriy Igumnov, RN
• Odaisa Igwe
• Melissa Rose Ihly
• Gretchen M Ihms
• Ihome Dialysis LLC
• Brian Ken Ikeda, PHARM.D.
• Ileap
• Kolose Ili
• Seyedeh Faye Iliaifar, PHARM D.
• Hoda A Ilias, DO

• Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.