Individual provider Active NPI

Rosemarie Mannino, MD

  • Medical Oncology Physician
  • Portland, OR
National Provider Identifier
1649392135
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
MD190254 Issued in OR
Practice address
3710 SW US Veteran Hospital Rd
Portland, OR 97239
Phone
(503) 220-8262
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 0101232280 VA
Medical Oncology Physician 207RX0202X MD190254 OR Primary

Addresses

Primary practice location

3710 SW US Veteran Hospital Rd
Portland, OR 97239

Mailing address

3303 SW Bond Ave
Hematology Oncology Division MC Ch14R
Portland, OR 97239-0001
Phone (503) 220-8262

Other practice location 1

McGuire Va Medical 1201 Broad Rock Blvd
Oncology division
Richmond, VA 23249-0001
Phone (804) 675-5446

Other practice location 2

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

Other identifiers 1

IdentifierTypeStateIssuer
207RX0202XMedicaidOR

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
I20190107000940 OR Practitioner - Medical OncologyPractitioner - Hematology 8426375247 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD190254ORMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Nov 30, 2018 Accepting new patients
University Professional Services CurrentSince Nov 30, 2018 Accepting new patients

Locations

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

3303 S Bond Ave
#14R
Portland, OR 97239

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

Interoperability endpoints

  • Direct secure messaging: rmannino113048@direct.ohsu.edu
  • Direct secure messaging: rosemarie.mannino.1@18826.direct.athenahealth.com

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1649392135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 SW BOND AVE",
            "address_2": "HEMATOLOGY ONCOLOGY DIVISION MC CH14R",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972390001",
            "telephone_number": "503-220-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERAN HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-220-8262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "McGuire Va Medical 1201 Broad Rock Blvd",
            "address_2": "Oncology division",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232490001",
            "country_code": "US",
            "telephone_number": "804-675-5446",
            "fax_number": "804-675-5447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-8311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNINO",
        "first_name": "ROSEMARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VA",
            "license": "0101232280",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "OR",
            "license": "MD190254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207RX0202X",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.