Organization Active NPI

Mercy Gate Medical, P.C.

  • Internal Medicine Physician
  • Beaverton, OR
National Provider Identifier
1619769593
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MERCY GATE MEDICAL, P.C.
Practice address
12050 SW Champlin LN
Beaverton, OR 97007-8600
Phone
(541) 908-2316
NPI assigned
May 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Authorized official

Name
Dr. Aly Mohamed, MDNPI 1659637544
Title
Ceo
Phone
(541) 908-2316

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12050 SW Champlin LN
Beaverton, OR 97007-8600

Mailing address

401 NE 19TH Ave Ste 200
Portland, OR 97232-4800

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1619769593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NE 19TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972324800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12050 SW CHAMPLIN LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970078600",
            "telephone_number": "541-908-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY GATE MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "ALY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-908-2316",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "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 May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.