Pacific Cardiovascular Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PACIFIC CARDIOVASCULAR CENTER, LLC

Practice address

550 Hawthorne Ave SE
Salem, OR 97301-5206

Phone

(971) 707-4525

NPI assigned

Nov 10, 2021

Organization subpart

No

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

Authorized official

Name

Raghunandan Kamineni, MDNPI 1659372407

Title

Medical Director

Phone

(971) 707-4525

Specialties & licenses 1

Addresses

Other names 1

• PACIFIC CARDIOVASCULAR SURGERY CENTER Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Pacific Cardiovascular Center LLC Dba Pacific Cardiovascular Surgery CenterCCN 38C0001122

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Cascade Cardiology LLC

  • Internal Medicine Physician
  • Salem, OR
  • NPI 1447202668

  Member Of

  NPD member
• Oregon Heart Center PC

  • Cardiovascular Disease Physician
  • Salem, OR
  • NPI 1902138969

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raghunandan Kamineni, MD

  • Cardiovascular Disease Physician
  • Salem, OR
  • NPI 1659372407
  NPD Authorized official
• Maziar Azadpour, M.D.

  • Cardiovascular Disease Physician
  • Salem, OR
  • NPI 1730131855
  NPD
• Kevin H Thompson, DO

  • Interventional Cardiology Physician
  • Salem, OR
  • NPI 1164587119
  NPD (past)

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1740946128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 HAWTHORNE AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015206",
            "telephone_number": "971-707-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 HAWTHORNE AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015206",
            "telephone_number": "971-707-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CARDIOVASCULAR CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "KAMINENI",
        "authorized_official_first_name": "RAGHUNANDAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "971-707-4525",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EMAIL",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "MEDICAL RECORDS",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "TEXT",
            "address_1": "550 Hawthorne Ave SE",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973015206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PACIFIC CARDIOVASCULAR SURGERY CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• P3 Health Partners-Oregon LLC
• P3 Medical Group PC
• Alexis Jizelle Pacheco
• Alyssa Pacheco
• Pacific Allcare LLC
• Pacific Coast Clinic Salem LLC
• Pacific Eye Group, PC.
• Pacific Family Medical Center LLC
• Pacific Family Medical Center LLC
• Pacific Family Medical Center LLC

• Ambulatory Surgical Clinic/Center in Salem, OR
• Providers in Salem, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.