NPIMap

Individual provider Active NPI

Derek S Halvorson, MD

  • Emergency Medicine Physician
  • Vancouver, WA
National Provider Identifier
1740234996
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00043686 Issued in WA
Practice address
600 NE 92ND Ave
Vancouver, WA 98664-3225
Phone
(360) 514-2142
Fax
(360) 514-6820
NPI assigned
May 20, 2006
Last updated
Dec 6, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD00043686 WA Primary

Addresses

Primary practice location

600 NE 92ND Ave
Vancouver, WA 98664-3225

Mailing address

PO Box 5037
Unit 282
Portland, OR 97208-5037
Phone (360) 514-2142

Other identifiers 2

IdentifierTypeStateIssuer
278165MedicaidOR
8398398MedicaidWA

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
I20070814000596 OR Practitioner - Emergency Medicine 3971583279 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Minnesota Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9205 SW Barnes Rd
Suite 20
Portland, OR 97225-6603
Phone (503) 216-2229

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.39 of 100Reported as group
Quality
83
Promoting interoperability
100
Improvement activities
40
Cost
89.32

Merit-based Incentive Payment System (MIPS)

Final score
95.65 of 100Reported as group
Quality
98.12
Promoting interoperability
100
Improvement activities
40
Cost
80.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00043686WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Sep 1, 2006 Accepting new patients
Providence Health & Services Oregon Emergency Medicine Current Accepting new patients
Providence Health & Services Oregon Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 1, 2024 Accepting new patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Sep 1, 2006 Accepting new patients
Providence Health & Services Oregon CurrentSince Mar 15, 2025 Accepting new patients
Peacehealth Past Accepting new patients
Emergency Medicine Associates PC Emergency Medicine PastSince Oct 1, 2005 Accepting new patients

Locations

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

9205 SW Barnes Rd
Ste 20
Portland, OR 97225
Phone (503) 216-2229

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1740234996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5037",
            "address_2": "UNIT 282",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972085037",
            "telephone_number": "360-514-2142",
            "fax_number": "360-514-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NE 92ND AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643225",
            "telephone_number": "360-514-2142",
            "fax_number": "360-514-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVORSON",
        "first_name": "DEREK",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00043686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278165",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8398398",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.