Individual provider Active NPI

Niknam Nmi Eshraghi, M.D.

  • Surgery Physician
  • Portland, OR
National Provider Identifier
1649364696
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD18913 Issued in OR
Practice address
501 N Graham St Ste 555
Portland, OR 97227-2007
Phone
(503) 288-7535
Fax
(503) 288-7538
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD18913 OR Primary

Addresses

Primary practice location

501 N Graham St Ste 555
Portland, OR 97227-2007

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other identifiers 2

IdentifierTypeStateIssuer
1649364696MedicaidWA
150227MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referringsbs@1243.direct.myezyaccess.com The Oregon Clinic PC

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
I20050912001047 OR Practitioner - General Surgery 9537192430 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Oregon Health Sciences University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vibra Physicians LLCGroup PAC ID 8921233933, 30 clinicians
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

10300 NE Hancock St
Portland, OR 97220-3831
Phone (503) 257-5500

1111 NE 99TH Ave
Portland, OR 97220-9442

501 N Graham St
Suite 555
Portland, OR 97227-2007
Phone (503) 288-7535

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic, PC CurrentSince Jul 1, 2012 Accepting new patients
The Oregon Clinic PC CurrentSince Jul 1, 2012 Accepting new patients
Vibra Physicians LLC CurrentSince Nov 1, 2014 Accepting new patients
Legacy Emanuel Hospital & Health Center Past Accepting new patients
Surgical Center, Inc Surgery Past Accepting new patients

Locations

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

501 N Graham St
Ste 555
Portland, OR 97227
Phone (503) 288-7535

501 N Graham St
#5
Portland, OR 97227
Phone (503) 288-7535

10300 NE Hancock St
Portland, OR 97220
Phone (503) 257-5500

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

847 NE 19th Ave
Ste 300
Portland, OR 97232

4550 Lena Dr
Ste 225
Mechanicsburg, PA 17055
Phone (717) 591-5706

Interoperability endpoints

  • Direct secure messaging: neshraghi113415@oc.providencedirect.org

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 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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1649364696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 555",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272007",
            "telephone_number": "503-288-7535",
            "fax_number": "503-288-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESHRAGHI",
        "first_name": "NIKNAM",
        "middle_name": "NMI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD18913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649364696",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150227",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referringsbs@1243.direct.myezyaccess.com",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "501 N Graham St Ste 555",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972272007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.