Individual provider Active NPI

Rajan P Kulkarni, M.D.

  • Dermatology Physician
  • Portland, OR
National Provider Identifier
1902040777
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD186821 Issued in OR
Practice address
3303 SW Bond Ave Ste 16
Portland, OR 97239
Phone
(503) 418-3376
Fax
(503) 494-6968
NPI assigned
Apr 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A113764 CA
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X MD186821 OR Primary

Addresses

Primary practice location

3303 SW Bond Ave Ste 16
Portland, OR 97239

Mailing address

3303 SW Bond Ave Ste 16
Portland, OR 97239-4501
Phone (503) 418-3376

Other practice location 1

200 Med Plaza Bldg 465
Los Angeles, CA 90095-2604
Phone (310) 825-0631

Other practice location 2

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000

Other practice location 3

200 Med Plaza Bldg 465
Los Angeles, CA 90095-2604
Phone (310) 825-0631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20140923001818 CA Practitioner - Dermatology 9133348139 Reassigns benefits to 2 organizations
I20180516001172 OR Practitioner - Dermatology 9133348139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of California, Geffen School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions33
Removal or shaving of skin growth1-10
Skin biopsy13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A113764CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Jan 5, 2018 Accepting new patients
County of Los Angeles CurrentSince Jan 5, 2018 Accepting new patients
University Professional Services CurrentSince Apr 27, 2018 Accepting new patients
University Professional Services CurrentSince Apr 27, 2018 Accepting new patients
The Regents of the University of California Dermatology CurrentSince Aug 1, 2014 Accepting new patients

Locations

File 55737
Los Angeles, CA 90074

200 Medical Plz
Ste 465
Los Angeles, CA 90095
Phone (310) 825-5510

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

14445 Olive View Dr
#2C155
Sylmar, CA 91342
Phone (818) 364-3001

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

14445 Olive View Dr
Rm 6B119H
Sylmar, CA 91342
Phone (818) 364-3031

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3303 S Bond Ave
Ste 16
Portland, OR 97239
Phone (503) 418-3376

Interoperability endpoints

  • Direct secure messaging: rkulkarni108757@direct.ohsu.edu

Organizations & group practices 5

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 1

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": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1902040777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 SW BOND AVE STE 16",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-418-3376",
            "fax_number": "503-494-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 SW BOND AVE STE 16",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-418-3376",
            "fax_number": "503-494-6968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Med Plaza Bldg 465",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900952604",
            "country_code": "US",
            "telephone_number": "310-825-0631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "751 S Bascom Ave",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951282604",
            "country_code": "US",
            "telephone_number": "408-885-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Med Plaza Bldg 465",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900952604",
            "country_code": "US",
            "telephone_number": "310-825-0631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KULKARNI",
        "first_name": "RAJAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-23",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A113764",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "MD186821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.