Individual provider Active NPI

Timothy Nicholas Saruk, D.C.

  • Chiropractor
  • Portland, OR
National Provider Identifier
1659556207
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3733 Issued in OR
Practice address
806 SW Broadway Ste 350
Portland, OR 97205-3336
Phone
(503) 224-9513
Fax
(503) 224-9595
NPI assigned
Jan 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3733 OR Primary

Addresses

Primary practice location

806 SW Broadway Ste 350
Portland, OR 97205-3336

Mailing address

806 SW Broadway Ste 350
Portland, OR 97205-3336
Phone (503) 224-9513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111205000141 OR Practitioner - Chiropractic 1052586948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3934 NE MLK Blvd
Suite 108
Portland, OR 97212-1153
Phone (503) 381-1380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3733ORMDClinical Social Worker

Organizations & group practices 1

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": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199232000000",
    "number": "1659556207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 SW BROADWAY STE 350",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053336",
            "telephone_number": "503-224-9513",
            "fax_number": "503-224-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 SW BROADWAY STE 350",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053336",
            "telephone_number": "503-224-9513",
            "fax_number": "503-224-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARUK",
        "first_name": "TIMOTHY",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-02",
        "last_updated": "2008-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3733",
            "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 Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.