Individual provider Active NPI

Martin Jay Smilkstein, M.D.

  • Medical Toxicology (Emergency Medicine) Physician
  • Portland, OR
National Provider Identifier
1629301528
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Toxicology (Emergency Medicine) PhysicianTaxonomy code 207PT0002X
License
17517 Issued in OR
Practice address
3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Phone
(503) 220-8262
NPI assigned
Sep 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Toxicology (Emergency Medicine) Physician 207PT0002X 17517 OR Primary

Addresses

Primary practice location

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964

Mailing address

2536 NW Overton St
Portland, OR 97210-2441
Phone (503) 227-1814

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17517ORMDMedical Toxicology (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care NW Gresham PC CurrentSince Mar 28, 2013 Accepting new patients
Kayenta Alternative Rural Hospital Past Accepting new patients

Locations

2850 SE Powell Valley Rd
Ste 100
Gresham, OR 97080
Phone (503) 666-5050

2850 SE Powell Valley Rd
Gresham, OR 97080
Phone (503) 666-5050

Organizations & group practices 2

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": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1629301528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2536 NW OVERTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102441",
            "telephone_number": "503-227-1814",
            "fax_number": "503-224-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392964",
            "telephone_number": "503-220-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILKSTEIN",
        "first_name": "MARTIN",
        "middle_name": "JAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "OR",
            "license": "17517",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 9, 2009; 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.