Active NPI
Kenneth K.S. Mah, D.P.M.
- Foot & Ankle Surgery Podiatrist
- Beaverton, OR
National Provider Identifier
1619075868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- DP144
- Practice address
- 14355 SW Allen Blvd
Suite 120
Beaverton, OR 97005-4700 - Phone
- (503) 643-1737
- Fax
- (503) 643-4926
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | DP144 | OR | Primary |
Addresses
Primary practice location
14355 SW Allen Blvd
Suite 120
Beaverton, OR 97005-4700
Mailing address
14355 SW Allen Blvd
Suite 120
Beaverton, OR 97005-4700
Phone (503) 643-1737
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DP144 | OR | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cascade Foot and Ankle Specialists, LLC | Foot & Ankle Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Foot & Ankle Surgery Podiatrist
- Portland, OR
- NPI 1275791857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205884800000",
"number": "1619075868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14355 SW ALLEN BLVD",
"address_2": "SUITE 120",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970054700",
"telephone_number": "503-643-1737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14355 SW ALLEN BLVD",
"address_2": "SUITE 120",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970054700",
"telephone_number": "503-643-1737",
"fax_number": "503-643-4926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAH",
"first_name": "KENNETH",
"middle_name": "K.S.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2008-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "OR",
"license": "DP144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.