Active NPI
Mural J. Nishikawa, MD
- Internal Medicine Physician
- Portland, OR
National Provider Identifier
1700869286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD23145
- Practice address
- 800 SW 13TH Ave
Portland, OR 97205-1902 - Phone
- (503) 221-0161
- Fax
- (503) 274-1697
- NPI assigned
- Nov 29, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD23145 | OR | Primary |
Addresses
Primary practice location
800 SW 13TH Ave
Portland, OR 97205-1902
Mailing address
800 SW 13TH Ave
Portland, OR 97205-1902
Phone (503) 221-0161
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 286581 | Medicaid | OR | |
| 110239324 | Other | OR | RR MEDICARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD23145 | OR | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Primary Care Group, PC | Internal Medicine | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Milwaukie, OR
- NPI 1558572180
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340236800000",
"number": "1700869286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 SW 13TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051902",
"telephone_number": "503-221-0161",
"fax_number": "503-274-1697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 SW 13TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051902",
"telephone_number": "503-221-0161",
"fax_number": "503-274-1697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NISHIKAWA",
"first_name": "MURAL",
"middle_name": "J.",
"name_prefix": "Ms.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-29",
"last_updated": "2012-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD23145",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "286581",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "110239324",
"state": "OR"
}
],
"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 Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.