Individual provider Active NPI

Waseem Makhoul, MD

  • Allergy & Immunology Physician
  • Clackamas, OR
National Provider Identifier
1588862312
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MD150278 Issued in OR
Practice address
10365 SE Sunnyside Rd
Suite 245
Clackamas, OR 97015-5741
Phone
(503) 208-9144
Fax
(503) 698-1900
NPI assigned
Jul 3, 2007
Last updated
May 31, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD150278 OR Primary
Allergy & Immunology Physician 207K00000X MD60113845 WA

Addresses

Primary practice location

10365 SE Sunnyside Rd
Suite 245
Clackamas, OR 97015-5741

Mailing address

10365 SE Sunnyside Rd
Suite 245
Clackamas, OR 97015-5741
Phone (503) 208-9144

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
I20130919000752 OR Practitioner - Allergy/Immunology 5597857607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10365 SE Sunnyside Rd
Suite 245
Clackamas, OR 97015-5752
Phone (503) 208-9144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD150278ORMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Allergy & Asthma Clinic LLC CurrentSince Jun 3, 2013 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
North West Asthma Allergy Center PC PastSince Mar 27, 2018 Accepting new patients
Cogent Healthcare of Washington, PC Past Accepting new patients

Locations

10365 SE Sunnyside Rd
Ste 245
Clackamas, OR 97015
Phone (503) 208-9144

4285 Commercial St SE
Ste 120
Salem, OR 97302
Phone (503) 399-7474

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1588862312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10365 SE SUNNYSIDE RD",
            "address_2": "SUITE 245",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155741",
            "telephone_number": "503-208-9144",
            "fax_number": "503-698-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10365 SE SUNNYSIDE RD",
            "address_2": "SUITE 245",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155741",
            "telephone_number": "503-208-9144",
            "fax_number": "503-698-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKHOUL",
        "first_name": "WASEEM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "OR",
            "license": "MD150278",
            "primary": true
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "WA",
            "license": "MD60113845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.