Individual provider Active NPI

Da Pan Jin, M.D.

  • Hospitalist Physician
  • Portland, OR
National Provider Identifier
1821355835
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD200595 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd # Bte119
Portland, OR 97239-3011
Phone
(503) 494-1164
Fax
(503) 494-5502
NPI assigned
Apr 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD200595 OR
Internal Medicine Physician 207R00000X 141351 CA
Hospitalist Physician 208M00000X A141351 CA
Hospitalist Physician 208M00000X MD200595 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd # Bte119
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd # Bte119
Portland, OR 97239-3011
Phone (503) 494-1164

Other practice location 1

1250 16th St
Suite 2304 Central Wing
Santa Monica, CA 90404-1249
Phone (310) 319-4698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160531001704 CA Practitioner - Internal Medicine 4284852203 Reassigns benefits to 1 organization
I20220818003170 OR Practitioner - Hospitalist 4284852203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Northwestern University Feinberg Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A141351CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Jun 30, 2016 Accepting new patients
University Professional Services CurrentSince Sep 1, 2022 Accepting new patients
University Professional Services CurrentSince Sep 1, 2022 Accepting new patients
Tuality Medical Group LLC Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
Tuality Medical Group LLC CurrentSince Dec 1, 2024 Accepting new patients
The Regents of the University of California Internal Medicine CurrentSince Jun 30, 2016 Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

1250 16th St
Ste 2304
Santa Monica, CA 90404
Phone (855) 488-9550

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

10123 SE Market St
Portland, OR 97216
Phone (503) 251-6355

3181 SW Sam Jackson Park Rd
#L579
Portland, OR 97239
Phone (503) 494-8652

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3181 SW Sam Jackson Park Rd
#119
Portland, OR 97239
Phone (503) 494-1164

Interoperability endpoints

  • Direct secure messaging: djin124967@direct.ohsu.edu

Organizations & group practices 6

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": "1334448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1821355835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # BTE119",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-1164",
            "fax_number": "503-494-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # BTE119",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-1164",
            "fax_number": "503-494-5502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 16th St",
            "address_2": "Suite 2304 Central Wing",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041249",
            "country_code": "US",
            "telephone_number": "310-319-4698",
            "fax_number": "310-319-4908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIN",
        "first_name": "DA",
        "middle_name": "PAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-15",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD200595",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "141351",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A141351",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD200595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.