Individual provider Active NPI

Juan A. Piantino, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Portland, OR
National Provider Identifier
1588866586
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
MD166936 Issued in OR
Practice address
3550 N Interstate Ave
Portland, OR 97227-1196
Phone
(503) 285-9321
Fax
(503) 249-5286
NPI assigned
Jun 1, 2007
Last updated
Jun 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LP01034 RI
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 125056270 IL
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X MD166936 OR Primary

Addresses

Primary practice location

3550 N Interstate Ave
Portland, OR 97227-1196

Mailing address

3550 N Interstate Ave
Portland, OR 97227-1196
Phone (503) 285-9321

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
I20140703001778 OR Practitioner - NeurologyPractitioner - Pediatric Medicine 7315162435 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP01034RIMDPediatrics Physician
125056270ILMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jul 7, 2014 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Pediatrics Current Accepting new patients
Bay Area Hospital District CurrentSince Mar 1, 2024 Accepting new patients
Bay Area Hospital District CurrentSince Mar 1, 2024 Accepting new patients
University Professional Services Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jun 7, 2014 Accepting new patients
University Professional Services Pediatrics Past Accepting new patients

Locations

Dept LA 25339
Pasadena, CA 91185

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

1775 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-8090

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3550 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

Interoperability endpoints

  • Direct secure messaging: jpiantino87584@direct.ohsu.edu

Organizations & group practices 7

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1588866586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 N INTERSTATE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271196",
            "telephone_number": "503-285-9321",
            "fax_number": "503-249-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 N INTERSTATE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271196",
            "telephone_number": "503-285-9321",
            "fax_number": "503-249-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIANTINO",
        "first_name": "JUAN",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "LP01034",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "IL",
            "license": "125056270",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "OR",
            "license": "MD166936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.