NPIMap

Individual provider Active NPI

Raghav Wusirika, MD

  • Nephrology Physician
  • Portland, OR
National Provider Identifier
1629192372
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD28438 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-3442
Fax
(503) 494-5330
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD60025851 WA
Nephrology Physician 207RN0300X MD28438 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-3442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080721000626 OR Practitioner - NephrologyPractitioner - Internal Medicine 7214000462 Reassigns benefits to 3 organizations
I20090701000309 WA Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Neurology 7214000462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Ohio State University College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, shared by 3 NPIs, 1,683 clinicians

Practice addresses (Care Compare)

11909 NE Glenn Widing Dr
Portland, OR 97220-9099
Phone (503) 255-3464

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

312 SE Stonemill Dr
Suite 150
Vancouver, WA 98684-3547
Phone (360) 254-2323

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1111

9105 NE Hwy 99
Suite 102
Vancouver, WA 98665-8974
Phone (360) 576-1350

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60025851WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jan 1, 2009 Accepting new patients
University Professional Services CurrentSince Jan 1, 2009 Accepting new patients
University Professional Services CurrentSince May 3, 2009 Accepting new patients

Locations

2111 Exchange St
Astoria, OR 97103
Phone (503) 325-4321

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

312 SE Stonemill Dr
Ste 150
Vancouver, WA 98684
Phone (360) 254-2323

Interoperability endpoints

  • Direct secure messaging: rwusirikamd23776@direct.ohsu.edu

Organizations & group practices 5

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1629192372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-3442",
            "fax_number": "503-494-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-3442",
            "fax_number": "503-494-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUSIRIKA",
        "first_name": "RAGHAV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD60025851",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OR",
            "license": "MD28438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.