NPIMap

Organization Active NPI

Grapevine Womens Health and Gynecology, LLC

  • Gynecology Physician
  • Hillsboro, OR
National Provider Identifier
1780021899
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
23173 Issued in OR
Legal business name
GRAPEVINE WOMENS HEALTH AND GYNECOLOGY, LLC
Practice address
5880 NE Cornell Rd Ste C
Hillsboro, OR 97124-9075
Phone
(503) 781-8846
NPI assigned
May 30, 2013
Last updated
Jun 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Authorized official

Name
Dr. Nicola Rotberg, MDNPI 1578644241
Title
Manager
Phone
(503) 781-8846

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
Gynecology Physician 207VG0400X 23173 OR Primary

Addresses

Primary practice location

5880 NE Cornell Rd Ste C
Hillsboro, OR 97124-9075

Mailing address

13124 NW Old Germantown Rd
Portland, OR 97231-2711
Phone (503) 781-8846

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130920000736 OR Part B Supplier - Clinic/Group Practice 4880838465 Receives reassigned benefits from 2 practitioners
Practice locations: Hillsboro, OR

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7230/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1780021899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13124 NW OLD GERMANTOWN RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972312711",
            "telephone_number": "503-781-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 NE CORNELL RD STE C",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971249075",
            "telephone_number": "503-781-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAPEVINE WOMENS HEALTH AND GYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-30",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "ROTBERG",
        "authorized_official_first_name": "NICOLA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-781-8846",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OR",
            "license": "23173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.