Individual provider Active NPI

Clara Ruiz

  • Psychiatry Physician
  • Portland, OR
National Provider Identifier
1881829596
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD162062 Issued in OR
Practice address
17720 NE Halsey St Ste a
Portland, OR 97230-6771
Phone
(503) 654-7654
Fax
(503) 654-7333
NPI assigned
May 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD162062 OR Primary

Addresses

Primary practice location

17720 NE Halsey St Ste a
Portland, OR 97230-6771

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004
Phone (541) 858-8170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, VA, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20131001000420 OR Practitioner - Psychiatry 6507011178 Reassigns benefits to 4 organizations
I20231102002778 VA Practitioner - Psychiatry 6507011178 Reassigns benefits to 6 organizations
I20240305001613 FL Practitioner - Psychiatry 6507011178 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD162062ORMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CMH Physician Services, LLC CurrentSince Apr 1, 2024 Accepting new patients
Warren Memorial Hospital, Inc. CurrentSince Apr 25, 2024 Accepting new patients
Baycare Behavioral Health Associates LLC Psychiatry CurrentSince Jan 10, 2024 Accepting new patients
CMH Physician Services, LLC Psychiatry CurrentSince Apr 1, 2024 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Warren Memorial Hospital, Inc. Psychiatry CurrentSince Apr 25, 2024 Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Apr 25, 2024 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Sep 11, 2023 Accepting new patients
Nchmd Inc Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 17, 2016 Accepting new patients
Shenandoah Memorial Hospital, Inc. CurrentSince Apr 25, 2024 Accepting new patients
Winchester Medical Center Psychiatry CurrentSince Apr 25, 2024 Accepting new patients
Legacy Emanuel Hospital & Health Center Psychiatry CurrentSince Sep 11, 2023 Accepting new patients
Sentara Medical Group CurrentSince Sep 24, 2023 Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 17, 2016 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Apr 25, 2024 Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 17, 2016 Accepting new patients
Nchmd, Inc CurrentSince Apr 17, 2024 Accepting new patients
Tuality Medical Group LLC CurrentSince Sep 1, 2023 Accepting new patients
Shenandoah Memorial Hospital Inc. Psychiatry CurrentSince Apr 25, 2024 Accepting new patients
Winchester Medical Center Psychiatry Current Accepting new patients
Landmark Hospital of Southwest Florida, LLC CurrentSince Apr 17, 2024 Accepting new patients
Winchester Medical Center CurrentSince Apr 25, 2024 Accepting new patients
Shenandoah Memorial Hospital, Inc. Current Accepting new patients
Baycare Behavioral Health Associates LLC Psychiatry CurrentSince Jan 10, 2024 Accepting new patients
Tuality Medical Group LLC CurrentSince Sep 1, 2023 Accepting new patients
Shenandoah Memorial Hospital, Inc. Past Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

21808 State Road 54
Lutz, FL 33549
Phone (727) 315-8612

4211 Van Dyke Rd
Lutz, FL 33558
Phone (813) 265-6300

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

6600 Madison St
New Pt Richey, FL 34652
Phone (727) 841-4611

3503 E Frontage Rd
Tampa, FL 33607
Phone (813) 586-8187

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

1400 SW 5th Ave
Ste 500
Portland, OR 97201

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

1225 NE 2nd Ave
Portland, OR 97232
Phone (503) 413-5051

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

351 Valley Health Way
Front Royal, VA 22630
Phone (540) 636-0300

200 Memorial Dr
Luray, VA 22835
Phone (540) 743-4561

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

1755 N Mecklenburg Ave
South Hill, VA 23970
Phone (434) 584-2273

1080 First Colonial Rd
Ste 403
Virginia Beach, VA 23454
Phone (757) 496-6537

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

240 Shenandoah St
Woodstock, VA 22664
Phone (540) 459-2808

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

Organizations & group practices 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1881829596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 HEATHROW WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044004",
            "telephone_number": "541-858-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17720 NE HALSEY ST STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972306771",
            "telephone_number": "503-654-7654",
            "fax_number": "503-654-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "CLARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-26",
        "last_updated": "2024-06-03",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD162062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.