PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1053419218
Family Medicine in Gresham, OR

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

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

Active since September 20, 2006

440 NW DIVISION ST, GRESHAM, OR 97030(503) 215-9500(503) 215-9525 Get Directions Write a Review

NPPES record last updated: June 20, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 20, 2025, Jun 19, 2024, Aug 31, 2023 and 1 more (4 updates tracked since 2020).

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About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1053419218), doing business as Providence Medical Group, is a healthcare organization registered as a family medicine in Gresham, Oregon and active in the NPI registry since September 2006. The organization maintains a secondary practice location in Portland and lists Donald W Anderson, Asst Sec Enroll, as its authorized official.

NPPES Registry Identity

NPI1053419218

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address440 NW DIVISION STGresham, OR 97030-5506

Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6494 · Fax (503) 215-6644

Phone(503) 215-9500

Fax(503) 215-9525

Organization SubpartNo

Authorized OfficialDonald W AndersonAsst Sec Enroll · (425) 358-9786

Enumeration DateSeptember 20, 2006

Last NPPES UpdateJune 20, 20254 updates tracked since enumeration

NPPES CertifiedJune 20, 2025

✔ NPI 1053419218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X

Also ListedClinic/CenterTaxonomy 261Q00000X

440 NW DIVISION ST, Gresham, OR 97030

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Other Names 1

Doing Business AsProvidence Medical Group

Secondary Practice Location 1

Location 15211 NE Glisan St Bldg CPortland, OR 97213-3052 · Phone (503) 215-6601

Other Identifiers 1

Medicaid287333OR

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 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, 11 practice at this address and 464 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

James Chong, DO

Family Practice

NPI 1821245788