| Dr John Oppenheimer, MD | |
|
1130 Nw 22nd Ave #220, Legacy Clinic Northwest, Portland, OR 97210-3025 | |
| (503) 413-8988 | |
| (503) 274-4815 |
| Full Name | Dr John Oppenheimer |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 1130 Nw 22nd Ave #220, Portland, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922071513 | NPI | - | NPPES |
| 0571232 | Medicaid | IA | |
| 143442 | Other | IHS | |
| 98999 | Other | BCWELLMARK 7TH ST | |
| 036058549002 | Medicaid | IL | |
| 273137 | Medicaid | OR | |
| 8497364 | Medicaid | WA | |
| 98986 | Other | BCWELLMARK WEST | |
| IL0182 | Other | JOHN DEERE | |
| 1571232 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036058549 (Illinois) | Primary |
| Entity Name | Legacy Clinics Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902827272 PECOS PAC ID: 0244144004 Enrollment ID: O20031117000089 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr John Oppenheimer, MD 1130 Nw 22nd Ave #220, Legacy Clinic Northwest, Portland, OR 97210-3025 Ph: (503) 413-8988 | Dr John Oppenheimer, MD 1130 Nw 22nd Ave #220, Legacy Clinic Northwest, Portland, OR 97210-3025 Ph: (503) 413-8988 |
Salona Shrestha, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4805 Ne Glisan St, Portland, OR 97213 Phone: 503-215-2392 | |
Dr. Emmanuel Trungtoan Tavan, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2800 N Vancouver Ave, Suite 230, Portland, OR 97227 Phone: 503-413-2901 | |
Ginevra Lois Liptan, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 6400 Sw Canyon Ct, Ste 100, Portland, OR 97221 Phone: 503-477-9616 Fax: 503-477-9808 | |
Donald Richard Sullivan, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Uhn67, Portland, OR 97239 Phone: 503-494-6949 | |
Dr. Victor Nguyen Pham, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 9205 Sw Barnes Rd, Portland, OR 97225 Phone: 503-216-2906 | |
Richa Uppal, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1849 Nw Kearney St Ste 200, Portland, OR 97209 Phone: 971-229-4545 Fax: 503-966-2427 | |
Reem Hasan, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Ppv 350, Portland, OR 97239 Phone: 503-494-8562 |