Organization Active NPI

Alpha Care Family Medicine

  • Primary Care Clinic/Center
  • Beaverton, OR
National Provider Identifier
1750906509
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ALPHA CARE FAMILY MEDICINE
Practice address
14455 SW Allen Blvd Ste 100
Beaverton, OR 97005-4428
Phone
(971) 708-4041
NPI assigned
Jun 8, 2020
Last updated
Sep 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Authorized official

Name
Dr. Amany BashirNPI 1245640572
Title
Physician
Phone
(971) 708-4041

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

14455 SW Allen Blvd Ste 100
Beaverton, OR 97005-4428

Mailing address

14455 SW Allen Blvd Ste 100
Beaverton, OR 97005-4428
Phone (971) 708-4041

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200824001824 OR Part B Supplier - Clinic/Group Practice 2264859172 Receives reassigned benefits from 1 practitioner
Practice locations: Beaverton, OR

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2188596Alpha Care Family Medicine14455 SW Allen Blvd, Suite #100, Beaverton, OR 97005Certificate of waiverJul 19, 2028

National Provider Directory

National Provider Directory

Locations

14455 SW Allen Blvd
Ste 100
Beaverton, OR 97005
Phone (971) 708-4041

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21989/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1750906509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14455 SW ALLEN BLVD STE 100",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054428",
            "telephone_number": "971-708-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14455 SW ALLEN BLVD STE 100",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054428",
            "telephone_number": "971-708-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA CARE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "BASHIR",
        "authorized_official_first_name": "AMANY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "971-708-4041",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.