NPIMap

Individual provider Active NPI

James Sok Chong, DO

  • Family Medicine Physician
  • Gresham, OR
National Provider Identifier
1821245788
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO154003 Issued in OR
Practice address
440 NW Division St
Gresham, OR 97030-5506
Phone
(503) 215-9500
NPI assigned
Aug 22, 2008
Last updated
Nov 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO154003 OR Primary

Addresses

Primary practice location

440 NW Division St
Gresham, OR 97030-5506

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other identifiers 2

IdentifierTypeStateIssuer
500616286MedicaidOR
P01038590OtherORRR MEDICARE (PH&S)

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jchong118079@oc.providencedirect.org

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
I20110630000503 OR Practitioner - Family Practice 8527246131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mid West Medical College, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3300 SE Dwyer Dr
Suite 304
Milwaukie, OR 97222-6548
Phone (503) 513-8043

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO154003ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Family Medicine Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jul 1, 2011 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2011 Accepting new patients
Providence Health & Services - Oregon Family Medicine Past Accepting new patients

Locations

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

3300 SE Dwyer Dr
Ste 304
Portland, OR 97222
Phone (503) 513-8043

417 SW 117th Ave
Ste 200
Portland, OR 97225
Phone (503) 216-1800

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1821245788",
    "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",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 NW DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305506",
            "telephone_number": "503-215-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "JAMES",
        "middle_name": "SOK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-22",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO154003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500616286",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE (PH&S)",
            "identifier": "P01038590",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jchong118079@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "417 SW 117th Ave Ste 200",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972255924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.