Individual provider Active NPI

James H Imatani, MD

  • Surgery Physician
  • Portland, OR
National Provider Identifier
1891707766
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD12935 Issued in OR
Practice address
5050 NE Hoyt St Ste 610
Portland, OR 97213-2985
Phone
(503) 467-4761
Fax
(503) 467-4766
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD12935 OR Primary

Addresses

Primary practice location

5050 NE Hoyt St Ste 610
Portland, OR 97213-2985

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other identifiers 1

IdentifierTypeStateIssuer
180554MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jimatani132869@oc.providencedirect.org
Direct Messaging Address jimatani132869@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
I20101101001266 OR Practitioner - General SurgeryPractitioner - Surgical Oncology 5799979944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Surgical Oncology
Education
University of Colorado School of Medicine, Denver, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

5050 NE Hoyt St
Suite 610
Portland, OR 97213-2985
Phone (503) 467-4761

Hospital & facility affiliations

  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy28
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2017 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2017 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2017 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2017 Accepting new patients
Surgical Oncology Associates, P,C. Surgery Past Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

1510 Division St
Ste 210
Oregon City, OR 97045
Phone (503) 655-6313

5050 NE Hoyt St
Ste 610
Portland, OR 97213
Phone (503) 467-4761

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

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

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

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

Organizations & group practices 7

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 2

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1891707766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST STE 610",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132985",
            "telephone_number": "503-467-4761",
            "fax_number": "503-467-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMATANI",
        "first_name": "JAMES",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD12935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180554",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jimatani132869@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1510 Division St Ste 210",
            "city": "Oregon City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970451599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jimatani132869@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 610",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.