NPIMap

Individual provider Active NPI

Liliya Kraynov

  • Emergency Medicine Physician
  • Portland, OR
National Provider Identifier
1871948042
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD193574 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd # CDW-Em
Portland, OR 97239-3011
Phone
(503) 494-7500
NPI assigned
Apr 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD193574 OR Primary

Addresses

Primary practice location

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

Mailing address

3181 SW Sam Jackson Park Rd # CDW-Em
Portland, OR 97239-3011
Phone (503) 494-7500

Other practice location 1

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-4105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221109003058 AZ Practitioner - Emergency Medicine 5496048738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Arizona College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

5102 W Campbell Ave
Phoenix, AZ 85031-1703
Phone (602) 344-5011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.59 of 100Reported as group
Quality
81.55
Promoting interoperability
100
Improvement activities
40
Cost
79.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD193574ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc Current Accepting new patients
District Medical Group, Inc Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
District Medical Group, Inc Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
District Medical Group, Inc Family Medicine Past Accepting new patients

Locations

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

Interoperability endpoints

  • Direct secure messaging: lkraynov78659@direct.valleywisehealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1871948042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # CDW-EM",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # CDW-EM",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Holmes St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082640",
            "country_code": "US",
            "telephone_number": "816-404-4105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAYNOV",
        "first_name": "LILIYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD193574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.