Individual provider Active NPI

Ishmael Togamae, MD, MPH & TM

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1578875696
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD161834 Issued in OR
Practice address
12710 SE Division St
Portland, OR 97236-3134
Phone
(503) 988-3601
Fax
(503) 988-4167
NPI assigned
Jul 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MDR-5905 HI
Family Medicine Physician 207Q00000X MD161834 OR Primary

Addresses

Primary practice location

12710 SE Division St
Portland, OR 97236-3134

Mailing address

421 SW Oak St
Portland, OR 97204-1817
Phone (503) 988-7468

Other identifiers 2

IdentifierTypeStateIssuer
22959MedicaidOR
096511MedicaidOR

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
I20130913000681 OR Practitioner - Family Practice 4880838754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
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

600 NE 8TH St
Gresham, OR 97030-7317
Phone (503) 988-7468

Hospital & facility affiliations

  • Adventist Health Portland Hospital, Portland, OR, CCN 380060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDR-5905HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County Current Accepting new patients
Multnomah County CurrentSince Aug 10, 2013 Accepting new patients
Multnomah County CurrentSince Aug 10, 2013 Accepting new patients

Locations

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

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

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

Interoperability endpoints

  • Direct secure messaging: itogamae120123@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 1

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": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1578875696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SW OAK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041817",
            "telephone_number": "503-988-7468",
            "fax_number": "503-988-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12710 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972363134",
            "telephone_number": "503-988-3601",
            "fax_number": "503-988-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOGAMAE",
        "first_name": "ISHMAEL",
        "credential": "MD, MPH & TM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MDR-5905",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD161834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22959",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096511",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.