Individual provider Active NPI

Amanda Rae Munk, M.D.

  • Emergency Medicine Physician
  • Portland, OR
National Provider Identifier
1811160385
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD151089 Issued in OR
Practice address
9155 SW Barnes Rd Ste 420
Portland, OR 97225
Phone
(503) 297-6334
Fax
(503) 297-2360
NPI assigned
Apr 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD60215283 WA
Emergency Medicine Physician 207P00000X MD151089 OR Primary

Addresses

Primary practice location

9155 SW Barnes Rd Ste 420
Portland, OR 97225

Mailing address

9155 SW Barnes Rd Ste 420
Portland, OR 97225-6631
Phone (503) 297-6334

Other practice location 1

600 NE 92nd Ave
Vancouver, WA 98664-3225
Phone (360) 514-2142

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
I20170109002894 OR Practitioner - Emergency Medicine 4082885967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.65 of 100Reported as group
Quality
98.12
Promoting interoperability
100
Improvement activities
40
Cost
80.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD151089ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Nov 20, 2016 Accepting new patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Nov 20, 2016 Accepting new patients

Locations

9155 SW Barnes Rd
Ste 420
Portland, OR 97225
Phone (503) 297-6334

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

Organizations & group practices 2

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": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1811160385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 420",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256631",
            "telephone_number": "503-297-6334",
            "fax_number": "503-297-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 420",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-297-6334",
            "fax_number": "503-297-2360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 NE 92nd Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986643225",
            "country_code": "US",
            "telephone_number": "360-514-2142",
            "fax_number": "360-514-6820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNK",
        "first_name": "AMANDA",
        "middle_name": "RAE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60215283",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD151089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.