211INFO — NPI 1104643428 (Licensed & Credentialed Case Manager/Care Coordinator in PORTLAND, OR)

CMS-1500 Box 24J / 33a • NPI

1104643428

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

171M00000X

Licensed & Credentialed Case Manager/Care Coordinator

Box 32 Service Location & ZIP+4

7535 NE AMBASSADOR PL STE B, PORTLAND, OR, 97220-6807

✓ 9-Digit EDI 837 ZIP+4 (97220-6807)

Practice Phone & Referral Fax

(503) 222-5555

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1104643428 (211INFO) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1104643428` (NPI-2 Organization / Facility)
Provider / Legal Name	211INFO
Plain-English Specialty	Licensed & Credentialed Case Manager/Care Coordinator NUCC Code: `171M00000X` (Case Manager/Care Coordinator)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	7535 NE AMBASSADOR PL STE B, PORTLAND, OR, 97220-6807
Practice Telephone / Fax	Tel: (503) 222-5555
Administrative Mailing Address	7535 NE AMBASSADOR PL STE B, PORTLAND, OR, 97220-6807
Enumeration & Last Sync	Enumerated: 2024-09-26 \| CMS Record Updated: 2024-09-26
Authorized Official	CARA KANGAS (Director of Partnerships)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

7535 NE AMBASSADOR PL STE B, PORTLAND, OR, 97220-6807

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Plain-English Taxonomy & CMS Crosswalk (171M00000X)

What Does Taxonomy Code 171M00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 171M00000X translates to:
"Licensed & Credentialed Case Manager/Care Coordinator"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Case Manager/Care Coordinator for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (211INFO)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`171M00000X` — Case Manager/Care Coordinator Plain English: Licensed & Credentialed Case Manager/Care Coordinator	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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211INFO (NPI #1104643428)