Individual provider Active NPI

John Philip Muench, MD

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1568470029
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD19563 Issued in OR
Practice address
12121 E Burnside St
Portland, OR 97216-3737
Phone
(971) 361-7700
NPI assigned
Aug 3, 2006
Last updated
Aug 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD19563 OR Primary

Addresses

Primary practice location

12121 E Burnside St
Portland, OR 97216-3737

Mailing address

6819 SE 34TH Ave
Portland, OR 97202-8211

Other identifiers 1

IdentifierTypeStateIssuer
075627MedicaidOR

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230908002887 OR Order and Referring Only - Family PracticePractitioner - Family Practice 4284627456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD19563ORMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1568470029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6819 SE 34TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972028211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163737",
            "telephone_number": "971-361-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUENCH",
        "first_name": "JOHN",
        "middle_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD19563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075627",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.