Individual provider Active NPI

Michael Joseph Mooney, MD

  • Surgery Physician
  • Vancouver, WA
National Provider Identifier
1609985647
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
043433 Issued in GA
Practice address
2211 E Mill Plain Blvd
Vancouver, WA 98661-4329
Phone
(360) 619-4270
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 043433 GA Primary

Addresses

Primary practice location

2211 E Mill Plain Blvd
Vancouver, WA 98661-4329

Mailing address

2211 E Mill Plain Blvd
Vancouver, WA 98661-4329
Phone (360) 619-4270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WA, OR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20050408000295 GA Practitioner - General Surgery 7315984622 Reassigns benefits to 1 organization
I20121017000598 WA Practitioner - General Surgery 7315984622 Reassigns benefits to 1 organization
I20130614000124 OR Practitioner - General Surgery 7315984622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
R Franklin University of Med & Sci/Chicago Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

2875 NE Stucki Ave
Hillsboro, OR 97124-5806
Phone (800) 813-2000

Hospital & facility affiliations

  • Kaiser Foundation Hospital Westside Hospital, Hillsboro, OR, CCN 380103

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043433GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Surgery CurrentSince Apr 28, 2025 Accepting new patients
Silverton Health CurrentSince Sep 1, 2020 Accepting new patients
Silverton Health CurrentSince Sep 1, 2020 Accepting new patients
Silverton Health Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Surgery CurrentSince Aug 27, 2019 Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

347 Fairview St
Silverton, OR 97381
Phone (503) 873-5667

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 6

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1609985647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 E MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614329",
            "telephone_number": "360-619-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 E MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614329",
            "telephone_number": "360-619-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "043433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.