Individual provider Active NPI

Gheorghe Emanuel Plesiu, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1902162829
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD195826 Issued in OR
Practice address
2400 SW Vermont St
Portland, OR 97219-1940
Phone
(503) 452-0915
Fax
(503) 768-9232
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MD195826 OR Primary

Addresses

Primary practice location

2400 SW Vermont St
Portland, OR 97219-1940

Mailing address

2400 SW Vermont St
Portland, OR 97219-1940
Phone (503) 452-0915

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
I20200323001175 OR Practitioner - Internal Medicine 7719124718 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD195826ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fanno Creek Clinic LLC Multi-Specialty CurrentSince Feb 1, 2020 Accepting new patients

Locations

2400 SW Vermont St
Portland, OR 97219
Phone (503) 452-0915

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1902162829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 SW VERMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972191940",
            "telephone_number": "503-452-0915",
            "fax_number": "503-768-9232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 SW VERMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972191940",
            "telephone_number": "503-452-0915",
            "fax_number": "503-768-9232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLESIU",
        "first_name": "GHEORGHE",
        "middle_name": "EMANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD195826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.