NPIMap

Individual provider Active NPI

Jake Walker Sharp, MD

  • Diagnostic Radiology Physician
  • Salem, OR
National Provider Identifier
1720465933
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD202293 Issued in OR
Practice address
2925 Ryan Dr SE
Salem, OR 97301-9687
Phone
(503) 399-1262
Fax
(503) 371-0777
NPI assigned
Apr 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD60876778 WA
Diagnostic Radiology Physician 2085R0202X MD202293 OR Primary

Addresses

Primary practice location

2925 Ryan Dr SE
Salem, OR 97301-9687

Mailing address

2925 Ryan Dr SE
Salem, OR 97301-9687
Phone (503) 399-1262

Other practice location 1

825 Eastlake Ave E
Seattle, WA 98109-4405
Phone (206) 520-5000

Other practice location 2

930 SW Abbey St
Newport, OR 97365-4820
Phone (541) 265-2244

Other identifiers 2

IdentifierTypeStateIssuer
500789539MedicaidOR
1720465933MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsharpcontractstaff278989@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210507002470 OR Practitioner - Diagnostic Radiology 0749597300 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santiam Memorial HospitalGroup PAC ID 6103729751, shared by 8 NPIs, 128 clinicians
Salem Clinic PCGroup PAC ID 7517954514, 96 clinicians
Salem Radiology Consultants PCGroup PAC ID 0446148498, 33 clinicians
Portland ClinicGroup PAC ID 8224942867, 93 clinicians

Practice addresses (Care Compare)

1401 N 10TH Ave
Stayton, OR 97383-1311
Phone (503) 769-2175

2020 Capitol St NE
Salem, OR 97301-0644
Phone (503) 399-2424

2925 Ryan Dr SE
Salem, OR 97301-9687
Phone (503) 399-1262

800 SW 13TH Ave
Portland, OR 97205-1902
Phone 50322101612110

Hospital & facility affiliations

  • Salem Hospital Hospital, Salem, OR, CCN 380051
  • Salem Health West Valley Hospital, Dallas, OR, CCN 381308
  • Samaritan Pacific Community Hospital Hospital, Newport, OR, CCN 381314
  • Samaritan North Lincoln Hospital Hospital, Lincoln City, OR, CCN 381302
  • Good Samaritan Regional Medical Center Hospital, Corvallis, OR, CCN 380014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Portland Clinic CurrentSince Dec 1, 2023 Accepting new patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
The Portland Clinic Laboratory Current Accepting new patients
Pacific Imaging Associates LLC Diagnostic Radiology CurrentSince Dec 1, 2024 Accepting new patients
Salem Clinic, PC CurrentSince Jul 1, 2021 Accepting new patients
Salem Radiology Consultants PC Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Salem Imaging LLC Diagnostic Radiology Past Accepting new patients
Salem Clinic, PC PastSince Jul 1, 2021 Accepting new patients

Locations

2725 SW Cedar Hills Blvd
Ste 225
Beaverton, OR 97005

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

800 SW 13th Ave
Portland, OR 97205
Phone (503) 221-0161

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

475 S Columbia River Hwy
Saint Helens, OR 97051
Phone (503) 397-8040

1165 Union St NE
Ste 200
Salem, OR 97301

2925 Ryan Dr SE
Salem, OR 97301
Phone (503) 399-1262

2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

9250 SW Hall Blvd
Tigard, OR 97223
Phone (503) 221-0161

19250 SW 65th Ave
Ste 300
Tualatin, OR 97062
Phone (503) 692-1242

Interoperability endpoints

  • Direct secure messaging: jsharpcontractstaff278989@samhealth.direct-ci.com

Organizations & group practices 9

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 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1720465933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 RYAN DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973019687",
            "telephone_number": "503-399-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 RYAN DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973019687",
            "telephone_number": "503-399-1262",
            "fax_number": "503-371-0777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Eastlake Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981094405",
            "country_code": "US",
            "telephone_number": "206-520-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "930 SW Abbey St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "OR",
            "postal_code": "973654820",
            "country_code": "US",
            "telephone_number": "541-265-2244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARP",
        "first_name": "JAKE",
        "middle_name": "WALKER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-27",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60876778",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD202293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500789539",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720465933",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsharpcontractstaff278989@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "930 SW Abbey St",
            "city": "Newport",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973654820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.