Individual provider Active NPI

Jeffrey J Horacek, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1790721215
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD18532 Issued in OR
Practice address
5050 NE Hoyt St
#203
Portland, OR 97213-2991
Phone
(503) 230-9224
Fax
(503) 230-9201
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD18532 OR Primary

Addresses

Primary practice location

5050 NE Hoyt St
#203
Portland, OR 97213-2991

Mailing address

5050 NE Hoyt St
#203
Portland, OR 97213-2991
Phone (503) 230-9224

Other identifiers 2

IdentifierTypeStateIssuer
080114MedicaidOR
110164099OtherORRR MEDICARE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040416000220 OR Practitioner - Internal Medicine 4183619539 Reassigns benefits to 2 organizations
Practice locations: Lake Oswego, OR; Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthy Connections Hood River LLCGroup PAC ID 3375884794, 2 clinicians

Practice addresses (Care Compare)

1700 12TH St
Suite B
Hood River, OR 97031-9540
Phone (541) 716-5786

Hospital & facility affiliations

  • Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318
  • Skyline Hospital Hospital, White Salmon, WA, CCN 501315

Merit-based Incentive Payment System (MIPS)

Final score
95 of 100Reported as group
Quality
83.34
Promoting interoperability
100
Improvement activities
40
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD18532ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Healthy Connections Hood River LLC Internal Medicine CurrentSince Mar 1, 2016 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2018 Accepting new patients
Internal Medicine of Oregon, LLC Internal Medicine Past Accepting new patients
NW Internal Medicine Past Accepting new patients

Locations

1700 12th St
Ste B
Hood River, OR 97031
Phone (541) 386-1006

33 Nichols Pkwy
Ste 300
Hood River, OR 97031
Phone (541) 716-5786

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

Interoperability endpoints

  • Direct secure messaging: jeffrey.horacek@79034615332868.direct.elationemr.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1790721215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "#203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132991",
            "telephone_number": "503-230-9224",
            "fax_number": "503-230-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "#203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132991",
            "telephone_number": "503-230-9224",
            "fax_number": "503-230-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORACEK",
        "first_name": "JEFFREY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD18532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080114",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110164099",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.