Pavel Mitaru, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO187078 Issued in OR

Practice address

5050 NE Hoyt St Ste 454
Portland, OR 97213-2984

Phone

(503) 215-6405

NPI assigned

Jun 8, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services - OregonGroup PAC ID 5395656284, 195 clinicians

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Home Care Services Home health agency, Portland, OR, CCN 387047
• Providence Home Health Home health agency, Portland, OR, CCN 387048
• Ageright Care at Home Home health agency, Milwaukie, OR, CCN 387151
• Providence Hospice Hospice, Portland, OR, CCN 381500
• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
• Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Oregon

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  • Family Medicine Physician
  • Hillsboro, OR
  • NPI 1003916354
  NPD
• Providence Health & Services - Oregon

  • Family Medicine Physician
  • Gresham, OR
  • NPI 1053419218
  NPD
• Providence Health & Services - Oregon

  • Clinic/Center
  • Hood River, OR
  • NPI 1750631784
  NPD
• Providence Health & Services Oregon

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Portland, OR
  • NPI 1396818993
  NPD
• Providence Health & Services Oregon

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Providence Health & Services - Oregon

  • Internal Medicine Physician
  • Sherwood, OR
  • NPI 1184729329

  Family Medicine

  NPD (past)

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

• Adams & Gray, Inc

  • Home Health Agency
  • Milwaukie, OR
  • NPI 1083611818
  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation
• Providence Health & Services Oregon

  • Community Based Hospice Care Agency
  • Portland, OR
  • NPI 1205924313
  Care Compare affiliation
• Providence Health & Services Oregon

  • General Acute Care Hospital
  • Milwaukie, OR
  • NPI 1366536963
  Care Compare affiliation
• Providence Health & Services Oregon

  • Home Health Agency
  • Portland, OR
  • NPI 1790873461
  Care Compare affiliation
• Western Health Resources

  • Home Health Agency
  • Portland, OR
  • NPI 1629475868
  Care Compare affiliation

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1760862494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST STE 454",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132984",
            "telephone_number": "503-215-6405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITARU",
        "first_name": "PAVEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "60835",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO187078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmitaru945478@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 454",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mississippi Health Center Medicinay LLC
• Scott David Mist, MACOM, PHD
• Kiran Mistry, D.D.S.
• Nupur Sanghavi Mistry, MD
• Priya Patil Mistry, DDS
• Mitch Bacon LLC
• Mitchell Physical Therapy Inc
• Ashlee Beth Mitchell Von Buttlar, PHD
• Noelle Shahnaz Mitchell-Jamal, PT, DPT
• Susan M Mitchell-Miller, FNP

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.