Active NPI
Prasanna Rama Chandran
- Family Medicine Physician
- Beaverton, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 26884
- Practice address
- 15950 SW Millikan Way
Beaverton, OR 97006 - Phone
- (503) 646-0161
- Fax
- (503) 643-7459
- NPI assigned
- Nov 22, 2006
- Last updated
- Sep 3, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26884 | OR | Primary |
Addresses
Primary practice location
15950 SW Millikan Way
Beaverton, OR 97006
Mailing address
15950 SW Millikan Way
Beaverton, OR 97006
Phone (503) 646-0161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 240412 | Medicaid | OR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pchandran1894@direct.theportlandclinic.net |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Ohio State University College of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
15950 SW Millikan Way
Beaverton, OR 97003-5170
Phone (503) 646-0161
800 SW 13TH Ave
Portland, OR 97205-1902
Phone 50322101612110
9250 SW Hall Blvd
Tigard, OR 97223-6721
Phone (503) 293-0161
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26884 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Portland Clinic Laboratory | Current | Accepting new patients | |
| Portland Clinic | Family Medicine | Current | Accepting new patients |
Locations
15950 SW Millikan Way
Beaverton, OR 97003
Phone (503) 646-0161
800 SW 13th Ave
Portland, OR 97205
Phone (503) 221-0161
9250 SW Hall Blvd
Tigard, OR 97223
Phone (503) 221-0161
Interoperability endpoints
- pchandran32034@theportlandclinic.gardenplot.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Medical Laboratory
- Portland, OR
- NPI 1053448795
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Legacy Good Samaritan Providers
- Clinic/Center
- Portland, OR
- NPI 1679597108
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1780608216
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
-
dba Providence St Vincent Medical Center
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
-
dba Providence Hospice
- Community Based Hospice Care Agency
- Portland, OR
- NPI 1205924313
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599091200000",
"number": "1861567729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15950 SW MILLIKAN WAY",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97006",
"telephone_number": "503-646-0161",
"fax_number": "503-643-7459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15950 SW MILLIKAN WAY",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97006",
"telephone_number": "503-646-0161",
"fax_number": "503-643-7459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANDRAN",
"first_name": "PRASANNA",
"middle_name": "RAMA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2020-09-03",
"certification_date": "2020-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "26884",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "240412",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pchandran1894@direct.theportlandclinic.net",
"affiliation": "N",
"address_1": "15950 SW Millikan Way",
"city": "Beaverton",
"state": "OR",
"country_code": "US",
"postal_code": "97006",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.