Individual provider Active NPI

Patricia Fogarty, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Portland, OR
National Provider Identifier
1801180260
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
MD166103 Issued in OR
Practice address
6350 NE Halsey St
Portland, OR 97213-4720
Phone
(503) 215-2669
NPI assigned
Jun 2, 2011
Last updated
Feb 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD166103 OR
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X MD166103 OR Primary

Addresses

Primary practice location

6350 NE Halsey St
Portland, OR 97213-4720

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other practice location 1

6410 NE Halsey St
Suite 300
Portland, OR 97213-4742
Phone (503) 215-4691

Other identifiers 1

IdentifierTypeStateIssuer
500667940MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pfogarty103944@oc.providencedirect.org

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
I20140513002346 OR Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 1557502978 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 Crater Lake Ave
Medford, OR 97504-6241
Phone (541) 732-6274

1500 Division St
RM 1005
Oregon City, OR 97045-1527
Phone (503) 215-2669

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.09 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Internal Medicine Current Accepting new patients
Providence Health & Services Oregon Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2020 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Providence Health & Services-Oregon CurrentSince Jul 1, 2020 Accepting new patients

Locations

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

1235 NE 47th Ave
Ste 148
Portland, OR 97213
Phone (503) 215-4601

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

6350 NE Halsey St
Portland, OR 97213
Phone (503) 215-0750

6410 NE Halsey St
Ste 300
Portland, OR 97213
Phone (503) 215-2273

Organizations & group practices 7

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 3

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": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1801180260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972134720",
            "telephone_number": "503-215-2669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6410 NE Halsey St",
            "address_2": "SUITE 300",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972134742",
            "country_code": "US",
            "telephone_number": "503-215-4691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "PATRICIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD166103",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "OR",
            "license": "MD166103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500667940",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pfogarty103944@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "6410 NE Halsey St Ste 300",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972134759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.