Active NPI
Faraz Ghoddusi, MD
- Family Medicine Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD209921
- Practice address
- 3303 S Bond Ave
Portland, OR 97239-4501 - Phone
- (503) 494-8573
- Fax
- (503) 494-3457
- NPI assigned
- May 24, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | MD209921 | OR | Primary |
Addresses
Primary practice location
3303 S Bond Ave
Portland, OR 97239-4501
Mailing address
3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8573
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Wisconsin School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311
Hospital & facility affiliations
- Ohsu Hospital and Clinics
- Adventist Health Portland
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Past | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
Interoperability endpoints
- fghoddusi141714@direct.ohsu.edu
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.
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
- Pharmacy
- Beaverton, OR
- NPI 1073054714
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Portland, OR
- NPI 1316354970
-
- Pediatrics Physician
- Medford, OR
- NPI 1225282122
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
-
- General Acute Care Hospital
- Portland, OR
- NPI 1801887658
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661817600000",
"number": "1982051561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3303 S BOND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394501",
"telephone_number": "503-494-8573",
"fax_number": "503-494-3457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3303 S BOND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394501",
"telephone_number": "503-494-8573",
"fax_number": "503-494-3457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHODDUSI",
"first_name": "FARAZ",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-24",
"last_updated": "2022-08-30",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD209921",
"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 Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.