Individual provider Active NPI

Abdul Hai Kazemy, M.D.

  • Internal Medicine Physician
  • Salem, OR
National Provider Identifier
1962589176
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD25197 Issued in OR
Practice address
1660 Oak St SE
Salem, OR 97301-6942
Phone
(503) 220-8262
Fax
(503) 316-8817
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD25197 OR Primary

Addresses

Primary practice location

1660 Oak St SE
Salem, OR 97301-6942

Mailing address

1663 Water St NE
67
Salem, OR 97303-6688
Phone (503) 220-8262

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
I20180326001353 OR Practitioner - Internal Medicine 3870855125 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25197ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center CurrentSince Jun 1, 2022 Accepting new patients
Daiya Healthcare PLLC Internal Medicine CurrentSince May 1, 2021 Accepting new patients
Healthcare for the Mid-Columbia Region Current Accepting new patients
Mid-Columbia Medical Center CurrentSince Jun 1, 2022 Accepting new patients

Locations

10435 SE Cora St
Portland, OR 97266
Phone (503) 760-1737

75 Shore Dr
Saint Helens, OR 97051
Phone (503) 397-2713

1620 E 12th St
The Dalles, OR 97058
Phone (541) 296-9151

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962589176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1663 WATER ST NE",
            "address_2": "67",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973036688",
            "telephone_number": "503-220-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 OAK ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973016942",
            "telephone_number": "503-220-8262",
            "fax_number": "503-316-8817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZEMY",
        "first_name": "ABDUL",
        "middle_name": "HAI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD25197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.