Individual provider Active NPI

Mary K Alvarez, MD

  • Family Medicine Physician
  • Portland, OH
National Provider Identifier
1619927944
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD28494 Issued in OR
Practice address
601 SW 4TH Ave
Portland, OH 97204
Phone
(503) 342-2520
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L8595 TX
Family Medicine Physician 207Q00000X MD28494 OR Primary

Addresses

Primary practice location

601 SW 4TH Ave
Portland, OH 97204

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

619 SW 6th Ave.
5th Fl
Portland, OR 97209-9720
Phone (503) 988-5183

Other identifiers 1

IdentifierTypeStateIssuer
022959MedicaidOR

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
I20080731000339 OR Practitioner - Family Practice 9537148697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Cynthia Gulick PCGroup PAC ID 2860487279, 23 clinicians

Practice addresses (Care Compare)

11900 SW Greenburg Rd
Tigard, OR 97223-6453
Phone (503) 620-5556

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD28494ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Nov 9, 2021 Accepting new patients
Multnomah County CurrentSince Nov 9, 2021 Accepting new patients
Cynthia Gulick, PC Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
Active Wellness Chiropractic,PC Past Accepting new patients
University Professional Services Past Accepting new patients
My Other Me PastSince Jun 1, 2024 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

5329 NE Mlk Jr Blvd
Portland, OR 97211
Phone (503) 988-3821

619 NW 6th Ave
Ste 300
Portland, OR 97209
Phone (503) 988-5020

11900 SW Greenburg Rd
Tigard, OR 97223
Phone (503) 386-5424

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1619927944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SW 4TH AVE",
            "city": "PORTLAND",
            "state": "OH",
            "postal_code": "97204",
            "telephone_number": "503-342-2520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 SW 6th Ave.",
            "address_2": "5th Fl",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972099720",
            "country_code": "US",
            "telephone_number": "503-988-5183",
            "fax_number": "503-988-5182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "MARY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L8595",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD28494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022959",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OH

Sources for this page

Verify at the official NPI Registry.