NPIMap

Individual provider Active NPI

Ehud Israel Zusman, MD

  • Urology Physician
  • Portland, OR
National Provider Identifier
1952492431
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD23403 Issued in OR
Practice address
800 SW 13TH Ave
Portland, OR 97205
Phone
(503) 221-0161
Fax
(503) 274-1697
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD23403 OR Primary

Addresses

Primary practice location

800 SW 13TH Ave
Portland, OR 97205

Mailing address

800 SW 13TH Ave
Portland, OR 97205
Phone (503) 221-0161

Other identifiers 1

IdentifierTypeStateIssuer
227882MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ezusman1769@direct.theportlandclinic.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110126000262 OR Practitioner - Urology 1557447307 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Temple University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland ClinicGroup PAC ID 8224942867, 93 clinicians

Practice addresses (Care Compare)

15950 SW Millikan Way
Beaverton, OR 97003-5170
Phone (503) 646-0161

5005 NE Sandy Blvd
Portland, OR 97213-1941
Phone (503) 233-6940

6640 SW Redwood LN
Portland, OR 97224-7187
Phone (603) 620-7358

800 SW 13TH Ave
Portland, OR 97205-1902
Phone 50322101612110

9250 SW Hall Blvd
Tigard, OR 97223-6721
Phone (503) 293-0161

Hospital & facility affiliations

  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23403ORMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Apr 1, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 1, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 1, 2015 Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 1, 2015 Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: ezusman1769@direct.theportlandclinic.net
  • Direct secure messaging: ezusman31835@theportlandclinic.gardenplot.direct-ci.com

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 3

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1952492431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-221-0161",
            "fax_number": "503-274-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-221-0161",
            "fax_number": "503-274-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUSMAN",
        "first_name": "EHUD",
        "middle_name": "ISRAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD23403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227882",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ezusman1769@direct.theportlandclinic.net",
            "affiliation": "N",
            "address_1": "800 SW 13th Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.