Active NPI
Joe Wayne Kurosu, M.D.
- Family Medicine Physician
- Portland, OR
National Provider Identifier
1952536351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD194463
- Practice address
- 7545 NE Ambassador PL
Portland, OR 97220-1367 - Phone
- (971) 978-4859
- NPI assigned
- May 28, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD194463 | OR | Primary |
Addresses
Primary practice location
7545 NE Ambassador PL
Portland, OR 97220-1367
Mailing address
5015 NE 26TH Ave
Portland, OR 97211-6322
Phone (971) 808-9282
Other practice location 1
2-1-16-3F Kitazawa
Setagaya-ku
Tokyo, Tokyo 1550031
JP
Phone 81354327177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD194463 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1952536351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5015 NE 26TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972116322",
"telephone_number": "971-808-9282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7545 NE AMBASSADOR PL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972201367",
"telephone_number": "971-978-4859"
}
],
"practiceLocations": [
{
"address_1": "2-1-16-3F Kitazawa",
"address_2": "Setagaya-ku",
"address_purpose": "LOCATION",
"city": "Tokyo",
"state": "Tokyo",
"postal_code": "1550031",
"country_code": "JP",
"telephone_number": "81354327177",
"fax_number": "81354327178",
"country_name": "Japan",
"address_type": "FGN"
}
],
"basic": {
"last_name": "KUROSU",
"first_name": "JOE",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-28",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD194463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.