Nicholas Carl Asakawa
Individual provider Active NPI Emergency Medicine Physician · Clackamas, OR
NPI 1790103463 · NPPES record last updated Feb 4, 2022
Key facts
- NPI
- 1790103463
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- MD180890 (OR)
- Practice address
- 10180 SE Sunnyside Rd
Clackamas, OR 97015-8970 - Phone
- (503) 819-0015
- NPI assigned
- Mar 31, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Tufts University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kaiser Foundation Health Plan of the Northwest
Practice addresses (Care Compare)
2400 Lancaster Dr NE
Salem, OR 97305-1221
Phone (800) 813-2000
Hospital & facility affiliations
- Kaiser Sunnyside Medical Center
- Kaiser Foundation Hospital Westside
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OR, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170825003341 | OR | Practitioner - Emergency Medicine | 0042509390 | Reassigns benefits to 1 organization |
| I20211118001970 | WA | Practitioner - Emergency Medicine | 0042509390 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 139397 | CA | MD | Mental Health Counselor |
| MD180890 | OR | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Emergency Medicine | Current |
Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Emergency Medicine | Current |
Accepting new patients |
| Kaiser Foundation Health Plan of Washington | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Emergency Medicine | Current | Accepting new patients |
Locations
10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880
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
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | MD180890 | OR | Yes |
Addresses
Primary practice location
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Mailing address
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (503) 961-0004
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Northwest Permanente PC |
Other providers in Clackamas, OR
- Armworks Hand Therapy, LLC
- David Arndt
- Adrienne Leigh Arnold
- Alfredo Luis Arraut
- Cory Paul Arsenault
- Lisa Ascura
- Lisa A Ashcraft
- Kaylynn Asher
- Jennifer Ashford
- Robert David Ashley
All providers in Clackamas, OR · Emergency Medicine Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.