NPIMap

Individual provider Active NPI

Nishanie Bisorca, MD

  • Family Medicine Physician
  • Beaverton, OR
National Provider Identifier
1801052477
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD170433 Issued in OR
Practice address
1960 NW 167TH PL Ste 100
Beaverton, OR 97006-4805
Phone
(503) 672-6000
Fax
(503) 672-6001
NPI assigned
Aug 4, 2008
Last updated
Dec 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A101787 CA
Family Medicine Physician 207Q00000X MD170433 OR Primary

Addresses

Primary practice location

1960 NW 167TH PL Ste 100
Beaverton, OR 97006-4805

Mailing address

1960 NW 167TH PL
Beaverton, OR 97006-4803
Phone (503) 672-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150625000690 OR Practitioner - Family Practice 6406902014 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Diego School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1960 NW 167TH PL
Suite 100
Beaverton, OR 97006-4805
Phone (503) 672-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A101787CAMDFamily Medicine Physician
MD170433ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Mar 3, 2015 Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Jan 11, 2016 Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Jan 11, 2016 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jun 24, 2017 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jun 24, 2017 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Mar 3, 2015 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Past Accepting new patients
Axminster Medical Group Past Accepting new patients

Locations

1960 NW 167th Pl
Beaverton, OR 97006
Phone (503) 531-2594

1960 NW 167th Pl
Ste 100
Beaverton, OR 97006
Phone (503) 531-3434

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

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

17332 SE Powell Blvd
Portland, OR 97236
Phone (503) 415-4110

3550 N Interstate Ave
Ofc
Portland, OR 97227
Phone (503) 285-9321

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

Interoperability endpoints

  • Direct secure messaging: nchalmers106875@direct.lhs.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1801052477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 NW 167TH PL",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064803",
            "telephone_number": "503-672-6000",
            "fax_number": "503-672-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 NW 167TH PL STE 100",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064805",
            "telephone_number": "503-672-6000",
            "fax_number": "503-672-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISORCA",
        "first_name": "NISHANIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A101787",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD170433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.