Active NPI
Nikhil Pillarisetti Rao, MD
- Child & Adolescent Psychiatry Physician
- Portland, OR
National Provider Identifier
1629211347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- MD191260
- Practice address
- 2801 N Gantenbein Ave
Portland, OR 97227-1623 - Phone
- (503) 413-3815
- NPI assigned
- Apr 10, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME127325 | FL | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | ME127325 | FL | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD191260 | OR | Primary |
Addresses
Primary practice location
2801 N Gantenbein Ave
Portland, OR 97227-1623
Mailing address
PO Box 3777
Portland, OR 97208-3777
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500758359 | Medicaid | OR | |
| 018849700 | Medicaid | FL |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silverton Health | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Psychiatry | Current | Accepting new patients |
| Silverton Health | Current | Accepting new patients | |
| Legacy Clinics LLC | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Clinics LLC | Current | Accepting new patients | |
| Silverton Health | Current | Accepting new patients |
Locations
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660
Interoperability endpoints
- nikhil.rao.1@3083.direct.athenahealth.com
Organizations & group practices 8
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.
-
- Clinic/Center
- Portland, OR
- NPI 1902827272
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
- General Acute Care Hospital
- Silverton, OR
- NPI 1669424354
-
- Rural Health Clinic/Center
- Sandy, OR
- NPI 1730472192
-
- Community/Retail Pharmacy
- Portland, OR
- NPI 1417977976
-
- Clinic/Center
- Silverton, OR
- NPI 1407396799
-
- Clinic/Center
- Molalla, OR
- NPI 1861116055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555027200000",
"number": "1629211347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3777",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 N GANTENBEIN AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271623",
"telephone_number": "503-413-3815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAO",
"first_name": "NIKHIL",
"middle_name": "PILLARISETTI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-10",
"last_updated": "2019-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME127325",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "FL",
"license": "ME127325",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "OR",
"license": "MD191260",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500758359",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "018849700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.