Individual provider Active NPI

Ahmad Fouad Bayomy, MD

  • Pediatric Orthopaedic Surgery Physician
  • Portland, OR
National Provider Identifier
1942575147
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
280092 Issued in MA
Practice address
3101 SW Sam Jackson Park Rd
Portland, OR 97239-3095
Phone
(503) 221-3424
NPI assigned
Mar 20, 2012
Sex
Male
Sole proprietor
No

Organizations & group practices 9

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.

Medicare Care Compare profile

Specialty
Orthopedic Surgery
Education
University of Washington School of Medicine, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box 8500 Lockbox
Suite 7642
Philadelphia, PA 19178

PO Box 8500 Lockbox
Suite 7642
Philadelphia, PA 19178-7642

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OR, WA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20221202002843 OR Practitioner - Orthopedic Surgery 5991029571 Reassigns benefits to 3 organizations
I20260527002173 WA Practitioner - Orthopedic Surgery 5991029571 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
280092MAMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current
since Dec 1, 2022
Accepting new patients
Providence Health & Services - Oregon Current
since Nov 28, 2022
Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Shriners Hospitals for Children Pediatric Orthopaedic Surgery Current Accepting new patients
Shriners Hospitals for Children Current
since Sep 9, 2023
Accepting new patients
Providence Health & Services Oregon Current
since Dec 1, 2022
Accepting new patients
Providence Health & Services - Oregon Current
since Nov 28, 2022
Accepting new patients
Shriners Hospitals for Children Orthopaedic Surgery Past Accepting new patients

Locations

3101 SW Sam Jackson Park Rd
#R
Portland, OR 97239
Phone (503) 241-5090

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

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

3101 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 221-3424

Interoperability endpoints

  • Direct secure messaging: abayomy159678@direct.ohsu.edu

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X 280092 MA Primary

Addresses

NPPES NPI Registry

Primary practice location

3101 SW Sam Jackson Park Rd
Portland, OR 97239-3095

Mailing address

3101 SW Sam Jackson Park Rd
Portland, OR 97239-3095
Phone (503) 221-3424

Other practice location 1

516 Carew St
Springfield, MA 01104
Phone (413) 787-2027

Other names 1

NPPES NPI Registry
  • Dr. Ahmad Fouad Bayomy Professional name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 24, 2022.

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1942575147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393095",
            "telephone_number": "503-221-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393095",
            "telephone_number": "503-221-3424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 Carew St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "01104",
            "country_code": "US",
            "telephone_number": "413-787-2027",
            "fax_number": "413-787-2054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAYOMY",
        "first_name": "AHMAD",
        "middle_name": "FOUAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "MA",
            "license": "280092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AHMAD",
            "last_name": "BAYOMY",
            "middle_name": "FOUAD",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.