Kirit S Shah M.D., P.C.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD12620 Issued in OR

Legal business name

KIRIT S SHAH M.D., P.C.

Doing business as

East Portland Urology Clinic

Practice address

171 NE 102ND Ave
Portland, OR 97220-4169

Phone

(503) 254-6418

Fax

(503) 254-1029

NPI assigned

Nov 20, 2012

Last updated

Nov 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Becky Jo Brewer, M.A.

Title

Office Manager

Phone

(503) 254-6418

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• East Portland Urology Clinic Doing business as

Locations

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1871837468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 NE 102ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204169",
            "telephone_number": "503-254-6418",
            "fax_number": "503-254-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 NE 102ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204169",
            "telephone_number": "503-254-6418",
            "fax_number": "503-254-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRIT S SHAH M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "BECKY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-254-6418",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "OR",
            "license": "MD12620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226662",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Portland Urology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elena Marie Kirchoff
• Melissa Merritt Kirchoffer-Talbott
• Kathleen Kirgin
• Jacquelynn Kirihara, ND
• Faith N Kirirah, NP
• Kirk Parker OD P C (Cedar Hills Vision Clinic)
• Desiree D Kirk, AGNP
• Edward Paul Kirk, MD
• Hannah Rae Kirk, DO
• Elzabeth Kirkaldie, LCSW

• Urology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Urology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.