Active NPI
Dennis S Momah, M.D.
- Internal Medicine Physician
- Portland, OR
National Provider Identifier
1598913592
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective Jan 19, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 36578
- Practice address
- 1425 NE 7TH Ave
Portland, OR 97232-1279 - Phone
- (360) 489-7727
- NPI assigned
- Sep 3, 2008
- Last updated
- Jun 15, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 36578 | GA | Primary |
Addresses
Primary practice location
1425 NE 7TH Ave
Portland, OR 97232-1279
Mailing address
1425 NE 7TH Ave
Portland, OR 97232-1279
Phone (360) 489-7727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36578 | GA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308096000000",
"number": "1598913592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 NE 7TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321279",
"telephone_number": "360-489-7727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 NE 7TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321279",
"telephone_number": "360-489-7727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOMAH",
"first_name": "DENNIS",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-03",
"last_updated": "2011-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "36578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.