Individual provider Active NPI

Ali Chisti, M.D., M.P.H.

  • Hospitalist Physician
  • Bend, OR
National Provider Identifier
1639582133
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
304838 Issued in NY
Practice address
2500 NE Neff Rd
Bend, OR 97701-6015
Phone
(541) 706-6892
Fax
(541) 706-6813
NPI assigned
Jun 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1639582133 HI
Hospitalist Physician 208M00000X 304838 NY Primary

Addresses

Primary practice location

2500 NE Neff Rd
Bend, OR 97701-6015

Mailing address

150 E 42ND St FL 9
New York, NY 10017-5699
Phone (646) 605-8186

Other practice location 1

91-2141 Fort Weaver Rd
Ewa Beach, HI 96706-1993
Phone (808) 691-3000

Other practice location 2

1356 Lusitana St
Ste. 510
Honolulu, HI 96813-2409
Phone (808) 586-2890

Other practice location 3

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (503) 813-3860

Other practice location 4

10 Union Sq E
New York, NY 10003-3314
Phone (212) 844-1808

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Northwest Permanente PC
Direct Messaging Address achristi160602@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170810001553 HI Practitioner - HospitalistPractitioner - Internal Medicine 8628349560 Reassigns benefits to 1 organization
I20211027003074 OR Practitioner - Internal Medicine 8628349560 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Oregon Health Sciences University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians
St Charles Health System IncGroup PAC ID 3870402852, shared by 10 NPIs, 174 clinicians

Practice addresses (Care Compare)

1380 Lusitana St
Honolulu, HI 96813-2448

2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 706-2768

91 -2127 Fort Weaver Rd
Ewa Beach, HI 96706-1993
Phone (808) 691-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1639582133HIMDInternal Medicine Physician
304838NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Jul 1, 2022 Accepting new patients
St. Charles Health System, Inc. Internal Medicine CurrentSince Oct 31, 2022 Accepting new patients
St. Charles Health System, Inc. CurrentSince Oct 31, 2022 Accepting new patients
St. Charles Health System, Inc. Internal Medicine Current Accepting new patients
Imhotep and Asclepius, LLC Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Oct 25, 2021 Accepting new patients
The Queens Medical Center Past Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
Bimc Faculty Practice PastSince Aug 2, 2020 Accepting new patients
St. Charles Health System, Inc. Internal Medicine Past Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients

Locations

91-2141 Fort Weaver Rd
Ewa Beach, HI 96706
Phone (808) 678-7000

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1639582133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E 42ND ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175699",
            "telephone_number": "646-605-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016015",
            "telephone_number": "541-706-6892",
            "fax_number": "541-706-6813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91-2141 Fort Weaver Rd",
            "address_purpose": "LOCATION",
            "city": "Ewa Beach",
            "state": "HI",
            "postal_code": "967061993",
            "country_code": "US",
            "telephone_number": "808-691-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1356 Lusitana St",
            "address_2": "Ste. 510",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968132409",
            "country_code": "US",
            "telephone_number": "808-586-2890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10180 SE Sunnyside Rd",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970158970",
            "country_code": "US",
            "telephone_number": "503-813-3860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Union Sq E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100033314",
            "country_code": "US",
            "telephone_number": "212-844-1808",
            "fax_number": "212-420-2025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHISTI",
        "first_name": "ALI",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-03",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "1639582133",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "304838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Northwest Permanente PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10180 SE Sunnyside Rd",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970158970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "achristi160602@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2500 NE Neff Rd",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.