NPIMap

Individual provider Active NPI

Irina Leonidovna Kiseleva, NP

  • Obstetrics & Gynecology Nurse Practitioner
  • Albany, OR
National Provider Identifier
1952533317
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
200950029NP Issued in OR
Practice address
705 Elm St SW Ste 200
Albany, OR 97321-1957
Phone
(541) 812-4850
NPI assigned
Aug 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 200950029NP OR Primary

Addresses

Primary practice location

705 Elm St SW Ste 200
Albany, OR 97321-1957

Mailing address

PO Box 1188
Corvallis, OR 97339-1188

Other identifiers 1

IdentifierTypeStateIssuer
200950029NPOtherORSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ikiseleva45127@samhealth.direct-ci.com

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
I20100208000439 OR Practitioner - Nurse Practitioner 7517000912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany General HospitalGroup PAC ID 9931097987, 191 clinicians

Practice addresses (Care Compare)

705 Elm St SW
Suite 200
Albany, OR 97321-1957
Phone (541) 812-4850

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
92.31
Promoting interoperability
100
Improvement activities
40
Cost
80.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital CurrentSince May 12, 2012 Accepting new patients
Albany General Hospital CurrentSince May 12, 2012 Accepting new patients
Albany General Hospital Current Accepting new patients
Firstcare Medical Foundation Past Accepting new patients

Locations

400 Hickory St NW
Ste 300
Albany, OR 97321
Phone (541) 812-5700

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

Organizations & group practices 4

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 53

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1250640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1952533317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1188",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 ELM ST SW STE 200",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211957",
            "telephone_number": "541-812-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISELEVA",
        "first_name": "IRINA",
        "middle_name": "LEONIDOVNA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-19",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "OR",
            "license": "200950029NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "200950029NP",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ikiseleva45127@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "705 Elm St SW Ste 200",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.