Active NPI
Alar Mirka, M.D.
- Internal Medicine Physician
- Portland, OR
National Provider Identifier
1831165398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD13685
- Practice address
- 1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2900 - Phone
- (503) 413-8988
- Fax
- (503) 274-4815
- NPI assigned
- Feb 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD13685 | OR | Primary |
Addresses
Primary practice location
1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2900
Mailing address
1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2900
Phone (503) 413-8988
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 151688 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD13685 | OR | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297814400000",
"number": "1831165398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 NW 22ND AVE",
"address_2": "SUITE 220",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972102900",
"telephone_number": "503-413-8988",
"fax_number": "503-274-4815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 NW 22ND AVE",
"address_2": "SUITE 220",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972102900",
"telephone_number": "503-413-8988",
"fax_number": "503-274-4815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRKA",
"first_name": "ALAR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-24",
"last_updated": "2011-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD13685",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "151688",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.