PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1073604955
Internal Medicine in Portland, OR
NPI Status: Active since September 27, 2006
Contact Information
1321 NE 99TH AVE
SUITE 100
PORTLAND, OR
ZIP 97220
Phone: (503) 215-9900
Fax: (503) 215-4055
- Organization
- Internal Medicine
- CLIA Number: 38D0706836
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-20-2025
About PROVIDENCE HEALTH & SERVICES - OREGON
This page provides the complete NPI Profile along with additional information for Providence Health & Services - Oregon, an internist established in Portland, Oregon operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1073604955 assigned on September 2006. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated June 2025. The provider's
- NPI
- 1073604955
- Provider Legal Name
- PROVIDENCE HEALTH & SERVICES - OREGON
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220
- Location Phone
- (503) 215-9900
- Location Fax
- (503) 215-4055
- Mailing Address
- PO BOX 31001 - 4180 PASADENA, CA 91110
- Mailing Phone
- (503) 215-6494
- Mailing Fax
- (503) 215-4055
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-27-2006
- Last Update Date
- 06-20-2025
- Code Navigator
An internist like Providence Health & Services - Oregon is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 198127 | MEDICAID (05) | OR |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 38D0706836
- Facility Type
- Physician Office
- Certificate Effective Date
- October 21, 2023
- Certificate Expiration Date
- October 20, 2025
- Laboratory Director
- KIRAN BEYER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Providence Health & Services - Oregon to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 7 | 3 | 6 | 0 | 4 | 9 | 5 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 14 | 3 | 12 | 0 | 8 | 9 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 4 + 3 + 1 + 2 + 0 + 8 + 9 + 1 + 0 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1073604955 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1346234606 | MARINA MEZEY MD Individual | Family Medicine | 1321 NE 99TH AVE SUITE 200 PORTLAND, OR 97220 (503) 215-4250 |
| 1447212865 | DR. JIMMY MING-YUH LIAO MD Individual | Family Medicine | 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1881641397 | MS. NORI ALEA TREVARTHEN FNP Individual | Nurse Practitioner (Family) | 1321 NE 99TH AVE STE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1427092139 | DR. STEVEN J MANDELBLATT M.D. Individual | Internal Medicine | 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1437194891 | DR. KAY M GATES MD Individual | Internal Medicine | 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220 (503) 215-4050 |
| 1780614727 | JODI K DEMUNTER MD Individual | Family Medicine | 1321 NE 99TH AVE SUITE 200 PORTLAND, OR 97220 (503) 215-4250 |
| 1417973561 | CRAIG L STEPHENS MD Individual | Family Medicine | 1321 NE 99TH AVE SUITE 200 PORTLAND, OR 97220 (503) 215-4250 |
| 1700971835 | DOLORES L FOGLIO FNP Individual | Nurse Practitioner | 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1831263953 | MS. SARA J DAVIS-RISEN Individual | Nurse Practitioner (Family) | 1321 NE 99TH AVE STE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1700072220 | LINDA JOYCE THIMSEN FREDERICKS FNP Individual | Nurse Practitioner (Family) | 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1750544037 | DR. DANIEL DEVEE ROBERTS M.D. Individual | Family Medicine | 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220 (503) 215-4014 |
| 1588814172 | ANNAMARIE BAIN FNP Individual | Nurse Practitioner (Family) | 1321 NE 99TH AVE STE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1619290863 | WAJMA NIAZI PA-C Individual | Physician Assistant | 1321 NE 99TH AVE STE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1255423158 | PATRICIA G GREEN N.P. Individual | Nurse Practitioner (Family) | 1321 NE 99TH AVE STE 200 PORTLAND, OR 97220 (503) 215-4250 |
| 1205866969 | LARLENE M DUNSMUIR FNP Individual | Nurse Practitioner (Family) | 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1750475356 | ELAINE R MARCUS MD Individual | Family Medicine | 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1427263151 | JOHN SELBY BARTON JR. M.D. Individual | Family Medicine | 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1588768717 | DR. ROBIN LYNNE REDWINE MD Individual | Family Medicine | 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220 (503) 215-9900 |
| 1558307546 | HEATHER BEECHER MD Individual | Family Medicine | 1321 NE 99TH AVE SUITE 200 PORTLAND, OR 97220 (503) 215-4250 |
| 1790793230 | JAMES MATTHEW BARTRUFF MD Individual | Internal Medicine | 1321 NE 99TH AVE SUITE 100 PORTLAND, OR 97220 (503) 215-9900 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073604955, enumerated in the NPI registry as an "organization" on September 27, 2006
The provider is located at 1321 Ne 99th Ave Suite 100 Portland, Or 97220 and the phone number is (503) 215-9900
This medical organization specializes in Internal Medicine with taxonomy code 207R00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 38D0706836 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on September 27, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.