Individual provider Active NPI

Michael A Valbuena, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Portland, OR
National Provider Identifier
1871536276
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
MD163523 Issued in OR
Practice address
17727 E Burnside St
Portland, OR 97233-4803
Phone
(503) 215-9800
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00040915 WA
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X MD163523 OR Primary

Addresses

Primary practice location

17727 E Burnside St
Portland, OR 97233-4803

Mailing address

17727 E Burnside St
Portland, OR 97233-4803
Phone (503) 215-9800

Other identifiers 1

IdentifierTypeStateIssuer
8296659MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mvalbuena298818@oc.providencedirect.org

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
I20150507001620 OR Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6002956117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00040915WAMDInternal Medicine Physician
MD163523ORMDHospice and Palliative Medicine (Internal Medicine) Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1871536276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17727 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972334803",
            "telephone_number": "503-215-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17727 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972334803",
            "telephone_number": "503-215-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALBUENA",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00040915",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "OR",
            "license": "MD163523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8296659",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvalbuena298818@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "17727 E Burnside St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972334803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.