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BOULDER CARE
NPI 1649838590
Family Medicine - Addiction Medicine in Portland, OR

Active since June 04, 2019
111 SW NAITO PKWY STE 200, PORTLAND, OR 97204(888) 316-0451 Get Directions Write a Review

NPPES record last updated: June 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 26, 2024, Jun 18, 2024, Sep 15, 2021 and 3 more (6 updates tracked since 2019).

About Boulder Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOULDER CARE (NPI 1649838590) is a healthcare organization registered as an addiction medicine in Portland, Oregon and active in the NPI registry since June 2019. The organization lists Pia Shivdasani, Vp Operations, Authorized Agent, as its authorized official.

NPPES Registry Identity

NPI1649838590
Entity TypeOrganization
Primary Taxonomy207QA0401X
Legal Business NameBOULDER CARE PROVIDER GROUP PA
Location Address111 SW NAITO PKWY STE 200Portland, OR 97204-3512
Mailing Address111 Sw Naito Pkwy Ste 200Portland, OR 97204-3512 · (503) 208-5061 · Fax (833) 260-2594
Phone(888) 316-0451
Organization SubpartNo
Authorized OfficialPia ShivdasaniVp Operations, Authorized Agent · (888) 288-4715
Enumeration DateJune 4, 2019
Last NPPES UpdateJune 26, 20246 updates tracked since enumeration
NPPES CertifiedJune 26, 2024
✔ NPI 1649838590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
Definition
A family medicine physician who specializes in the diagnosis and treatment of addictions.
111 SW NAITO PKWY STE 200, Portland, OR 97204
Open in Google Maps ↗

Other Names 1

Doing Business AsBoulder Care

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MORGAN LU
Nurse Practitioner
111 SW NAITO PKWY STE 200
PORTLAND, OR 97204
Multnomah County (866) 901-4860
DR. ELIZABETH BOGEL RYAN MD
Family Medicine (Addiction Medicine)
111 SW NAITO PKWY STE 200
PORTLAND, OR 97204
Multnomah County (888) 288-4710
DAVID DUNCAN MOORE
Peer Specialist
111 SW NAITO PKWY STE 200
PORTLAND, OR 97204
Multnomah County (866) 288-5885
BRANDI ELIZABETH JAMES
Peer Specialist
111 SW NAITO PKWY STE 200
PORTLAND, OR 97204
Multnomah County (888) 316-0451
SHAQUANNA DRAYTON DEAN
Peer Specialist
111 SW NAITO PKWY STE 200
PORTLAND, OR 97204
Multnomah County (704) 604-8343
ANA GEER PRS
Peer Specialist
111 SW NAITO PKWY STE 200
PORTLAND, OR 97204
Multnomah County (210) 818-9130
CASEY A RICHARDS PRS
Peer Specialist
111 SW NAITO PKWY STE 200
PORTLAND, OR 97204
Multnomah County (888) 288-4715

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boulder Care Provider Group PA's NPI number?

The NPI number for Boulder Care Provider Group PA is 1649838590. It was assigned to this organization in the NPPES registry on June 4, 2019. The provider is doing business as Boulder Care.

Where is Boulder Care Provider Group PA located?

Boulder Care Provider Group PA is located at 111 SW Naito Pkwy Ste 200, Portland, OR 97204. The listed phone number is (888) 316-0451.

What is Boulder Care Provider Group PA's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Addiction Medicine, with taxonomy code 207QA0401X.

What insurance does Boulder Care Provider Group PA accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of NC and 5 other insurers list Boulder Care Provider Group PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Boulder Care Provider Group PA was last updated on June 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.