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PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1003916354
Family Medicine in Hillsboro, OR

Active since September 25, 2006
5555 NE ELAM YOUNG PKWY, HILLSBORO, OR 97124(503) 216-1600 Get Directions Write a Review

NPPES record last updated: June 20, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 20, 2025, May 15, 2025, Jun 13, 2024 and 1 more (4 updates tracked since 2020).

About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1003916354), doing business as Providence Medical Group, is a healthcare organization registered as a family medicine in Hillsboro, Oregon and active in the NPI registry since September 2006. The organization lists Donald W Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1003916354
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address5555 NE ELAM YOUNG PKWYHillsboro, OR 97124-6452
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6494 · Fax (503) 215-6644
Phone(503) 216-1600
Organization SubpartNo
Authorized OfficialDonald W AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateSeptember 25, 2006
Last NPPES UpdateJune 20, 20254 updates tracked since enumeration
NPPES CertifiedJune 20, 2025
✔ NPI 1003916354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/CenterTaxonomy 261Q00000X
5555 NE ELAM YOUNG PKWY, Hillsboro, OR 97124
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Other Names 2

Doing Business AsProvidence Medical Group
Doing Business AsProvidence Medical Group Orenco

Other Identifiers 1

Medicaid227593OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Providence Health & Services - Oregon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

1,498

Medicare enrollment records show 1,498 clinicians reassign Medicare billing to Providence Health & Services - Oregon, which bills Medicare for the services they deliver. Of these, 10 practice at this address and 518 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 56

Internal Medicine250
Family Practice212
Nurse Practitioner210
Hospitalist96
Neurology57
Obstetrics/Gynecology57
Physical Therapist in Private Practice54
Clinical Psychologist53
48 other specialties509

Nearest to this location (20)

See all 1,498
Clarice Calopiz, M.D.
Family Practice
NPI 1316051410
5555 NE ELAM YOUNG PKWY
Hillsboro, OR 97124
(503) 216-1600
✔ PECOS✔ Accepts MedicareSame address
Brianne Difalco, FNP
Nurse Practitioner
NPI 1194470930
5555 NE ELAM YOUNG PKWY
Hillsboro, OR 97124
(503) 216-1600
✔ PECOS✔ Accepts MedicareSame address
Sarah Garey, D.O.
Family Practice
NPI 1952798159
5555 NE ELAM YOUNG PKWY
Hillsboro, OR 97124
(503) 216-1600
✔ PECOS✔ Accepts MedicareSame address
Tess Ishshalom, DO
Family Practice
NPI 1952706137
5555 NE ELAM YOUNG PKWY
Hillsboro, OR 97124
(503) 216-1600
✔ PECOS✔ Accepts MedicareSame address
Sheetal Mehndiratta, DO
Family Practice
NPI 1619321437
5555 NE ELAM YOUNG PKWY
Hillsboro, OR 97124
(503) 216-1600
✔ PECOS✔ Accepts MedicareSame address
Tira Nesset, FNP
Nurse Practitioner
NPI 1245617158
5555 NE ELAM YOUNG PKWY
Hillsboro, OR 97124
(503) 216-1600
✔ PECOS✔ Accepts MedicareSame address
Jordan Roth, M.D.
Family Practice
NPI 1649596875
5555 NE ELAM YOUNG PKWY
Hillsboro, OR 97124
(503) 216-1600
✔ PECOS✔ Accepts MedicareSame address
Nicole Trajano, M.D.
Family Practice
NPI 1518906114
5555 NE ELAM YOUNG PKWY
Hillsboro, OR 97124
(503) 216-1600
✔ PECOS✔ Accepts MedicareSame address
Carmen Kendall, MD
Family Practice
NPI 1780639575
5555 NE ELAM YOUNG PKWY
Hillsboro, OR 97124
(503) 216-1600
✔ PECOS✔ Accepts MedicareSame address
Lindsay Moore, PHD
Clinical Psychologist
NPI 1083227805
5555 NE ELAM YOUNG PKWY
Hillsboro, OR 97124
(503) 216-2600
✔ PECOS✔ Accepts MedicareSame address
Andrew Janssen, M.D.
Family Practice
NPI 1003891524
7529 SE TUALATIN VALLEY HWY
Hillsboro, OR 97123
(503) 681-4369
✔ PECOS✔ Accepts Medicare2.1 mi
Erica Hadley, MD
Pediatric Medicine
NPI 1134534928
10060 NE EVERGREEN PKWY
Hillsboro, OR 97124
(800) 813-2000
✔ PECOS2.5 mi
Jessamyn Bothwell, CNM
Certified Nurse Midwife (CNM)
NPI 1033845300
7305 SE CIRCUIT DR STE 260
Hillsboro, OR 97123
(503) 342-9928
✔ PECOS2.6 mi
Josiah Cobb, DPT
Physical Therapist in Private Practice
NPI 1821579053
7305 SE CIRCUIT DR STE 140
Hillsboro, OR 97123
(971) 504-4905
✔ Accepts Medicare2.6 mi
Erin Grinich, MD
Dermatology
NPI 1326501669
7305 SE CIRCUIT DR STE 230
Hillsboro, OR 97123
(503) 342-9925
✔ PECOS✔ Accepts Medicare2.6 mi
Amanda Kallunki, PSYD
Clinical Psychologist
NPI 1194250571
7305 SE CIRCUIT DR STE 270
Hillsboro, OR 97123
(503) 342-9931
✔ PECOS✔ Accepts Medicare2.6 mi
Brandy Langland, APRN-WHNP-BC
Nurse Practitioner
NPI 1164267464
7305 SE CIRCUIT DR STE 260
Hillsboro, OR 97123
(503) 342-9928
✔ PECOS✔ Accepts Medicare2.6 mi
Liberato Mukul, MD
Obstetrics/Gynecology
NPI 1932129491
7305 SE CIRCUIT DR STE 260
Hillsboro, OR 97123
(503) 342-9928
✔ PECOS✔ Accepts Medicare2.6 mi
Kevin Woolf, MD
Cardiovascular Disease (Cardiology)
NPI 1265580054
7305 SE CIRCUIT DR STE 220
Hillsboro, OR 97123
(503) 962-1000
✔ PECOS✔ Accepts Medicare2.6 mi
Robert Crouse, M.D.
Internal Medicine
NPI 1659339083
7305 SE CIRCUIT DR STE 270
Hillsboro, OR 97123
(503) 342-9931
✔ PECOS✔ Accepts Medicare2.6 mi
See all 1,498 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Providence Health & Services - Oregon's NPI number?

The NPI number for Providence Health & Services - Oregon is 1003916354. It was assigned to this organization in the NPPES registry on September 25, 2006. The provider is doing business as Providence Medical Group and Providence Medical Group Orenco.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 5555 NE Elam Young Pkwy, Hillsboro, OR 97124. The listed phone number is (503) 216-1600.

What is Providence Health & Services - Oregon's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Providence Health & Services - Oregon enrolled in Medicare?

Yes. Providence Health & Services - Oregon is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Providence Health & Services - Oregon?

According to the CMS Revalidation Reassignment List (October 2026 release), 1,498 clinicians in 56 Medicare specialties reassign their Medicare billing to Providence Health & Services - Oregon. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (250), Family Practice (212) and Nurse Practitioner (210). Of these, 10 practice at this address and 518 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Providence Health & Services - Oregon accept?

Health plans from Providence Health Plan list Providence Health & Services - Oregon 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 Providence Health & Services - Oregon was last updated on June 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.