Individual provider Active NPI

Vesna A Jovanovic, MD

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1780640508
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD23109 Issued in OR
Practice address
700 NE Multnomah St
Suite 400
Portland, OR 97232-2131
Phone
(503) 292-9560
Fax
(503) 292-9510
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD23109 OR Primary

Addresses

Primary practice location

700 NE Multnomah St
Suite 400
Portland, OR 97232-2131

Mailing address

9450 SW Barnes Rd
Suite 100
Portland, OR 97225-6619
Phone (503) 292-9560

Other identifiers 1

IdentifierTypeStateIssuer
287016MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100813000028 OR Practitioner - Family Practice 4385778331 Reassigns benefits to 1 organization
I20230523002813 WA Practitioner - Family Practice 4385778331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

1700 NE 102ND Ave
Portland, OR 97220-3804
Phone (800) 813-2000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 11, 2016 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Jan 11, 2016 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Jan 31, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine Current Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1780640508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9450 SW BARNES RD",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256619",
            "telephone_number": "503-292-9560",
            "fax_number": "503-292-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE MULTNOMAH ST",
            "address_2": "SUITE 400",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322131",
            "telephone_number": "503-292-9560",
            "fax_number": "503-292-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOVANOVIC",
        "first_name": "VESNA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD23109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287016",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.