PORTLAND PAIN INSTITUTE LLC (NPI# 1376926360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376926360 |
| Entity Type | Organization |
| Organization Name | PORTLAND PAIN INSTITUTE LLC |
| Practice Address |
501 N Graham St Ste 500 Portland OR 97227-2003 |
| Mailing Address |
Po Box 674074 Dallas TX 75267-4074 |
| Practice Telephone | 2143963936 |
| Practice Fax Number | 2143784664 |
| Mailing Telephone | 2143963936 |
| Mailing Fax Number | 2143784664 |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2015-07-08 |
| Authorized Official Name | MISS BRANDY KAY BARROW (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2143963936 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | MD157718 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
501 N GRAHAM ST STE 500 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-2003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1891101671 | Shushaun Badalian | Nurse Practitioner | 406 North Beech Street, Portland, OR 97227 | 2014-07-01 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447764485 | Columbia Neurosurgical Trauma, LLC | Neurological Surgery | 1040 Nw 22nd Ave Ste 630, Portland, OR 97210-3041 | 2017-11-29 |
| 1194178590 | Philippe Magown | Neurological Surgery | 3303 Sw Bond Ave # Ch8n, Department of Neurological Surgery, Ohsu, Portland, OR 97239-4501 | 2016-07-20 |
| 1922475813 | Willliam Leonard Debolt | Neurological Surgery | 7419 Nw Cornell Rd, Portland, OR 97229-6901 | 2015-08-26 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| 1366860009 | Kathryn Wagner | Neurological Surgery | 3101 Sw 13th Ave Apt 19, Portland, OR 97239-3071 | 2014-03-31 |
| 1699038323 | James Steve Heiden | Neurological Surgery | 2496 Nw 141st Pl, Portland, OR 97229-7078 | 2012-06-18 |
| 1942578026 | Nw Neurosurgery LLC | Neurological Surgery | 311 Nw 12th Ave Unit 1003, Portland, OR 97209-2995 | 2011-12-05 |
| 1306005319 | Hatem Adel Sabry | Neurological Surgery | 3181 Sw Sam Jackson Park Rd # L579, Portland, OR 97239-3011 | 2008-06-04 |
| 1639374440 | Frederick T Waller Md PC | Neurological Surgery | 9155 Sw Barnes Rd Ste 211, Portland, OR 97225-6629 | 2007-06-20 |
| 1356550206 | Ahmed M. Raslan | Neurological Surgery | 3181 Sw Sam Jackson Road, Portland, OR 97239 | 2007-05-21 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.