SUSAN E OMURA MD NPI 1477576239

NPI Information

NPI: 1477576239
Provider Name: SUSAN E OMURA, MD
Classification: Emergency Medicine - 207PP0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
2801 N GANTENBEIN AVE
PORTLAND, OR
ZIP 97227
Phone: (503) 413-4121
Get Directions

Susan E Omura, MD is a pediatric emergency medicine emergency medicine in Portland, OR. The provider is pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. Susan E Omura, MD NPI is 1477576239. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2801 N GANTENBEIN AVE
PORTLAND, OR
ZIP 97227-623
Phone: (503) 413-4121

The NPI 1477576239 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 2/4/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207PP0204X	Emergency Medicine	Pediatric Emergency Medicine	MD23697	OREGON	Yes
2	208000000X	Pediatrics		MD23697	OREGON	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	286909	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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