PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1073604955
Internal Medicine in Portland, OR

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

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since September 27, 2006

1321 NE 99TH AVE, SUITE 100, PORTLAND, OR 97220(503) 215-9900(503) 215-4055 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, Sep 24, 2020 (3 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 1073604955), doing business as Providence Medical Group, is a healthcare organization registered as an internal medicine in Portland, 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

NPI1073604955

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address1321 NE 99TH AVE, SUITE 100Portland, OR 97220-9437

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

Phone(503) 215-9900

Fax(503) 215-4055

Organization SubpartNo

Authorized OfficialDonald W AndersonAssistant Secretary Of Enrollments · (425) 358-9786

Enumeration DateSeptember 27, 2006

Last NPPES UpdateJune 20, 20253 updates tracked since enumeration

NPPES CertifiedJune 20, 2025

✔ NPI 1073604955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

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.

Also ListedClinic/CenterTaxonomy 261Q00000X

1321 NE 99TH AVE, Portland, OR 97220

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Other Names 2

Doing Business AsProvidence Medical Group

Doing Business AsProvidence Medical Group Gateway Immediate Care

Other Identifiers 1

Medicaid198127OR

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, 29 practice at this address and 626 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

Kiran Beyer, MD

Emergency Medicine

NPI 1457393670

1321 NE 99TH AVE STE 100
Portland, OR 97220

(503) 215-9900

✔ PECOS✔ Accepts MedicareSame address

Rima Chamie, MD

Family Practice

NPI 1316993801

1321 NE 99TH AVE SUITE 200
Portland, OR 97220

(503) 215-4250

✔ PECOS✔ Accepts MedicareSame address

Maria Constante, MD

Family Practice

NPI 1104856285

1321 NE 99TH AVE SUITE 200
Portland, OR 97220

(503) 215-4250

✔ PECOS✔ Accepts MedicareSame address

Alanna De Mello, MD

Family Practice

NPI 1124606975

1321 NE 99TH AVE STE 200
Portland, OR 97220

(503) 215-4250

✔ PECOS✔ Accepts MedicareSame address

Gina Easley, FNP

Nurse Practitioner

NPI 1427357680

1321 NE 99TH AVE STE 100
Portland, OR 97220

(503) 215-9900

✔ PECOS✔ Accepts MedicareSame address

John Ellison, FNP

Nurse Practitioner

NPI 1245672286

1321 NE 99TH AVE STE 100
Portland, OR 97220

(503) 215-9900

✔ PECOS✔ Accepts MedicareSame address

Barbara Esselink

Internal Medicine

NPI 1548451479

1321 NE 99TH AVE SUITE 100
Portland, OR 97220

(503) 215-4050

✔ PECOS✔ Accepts MedicareSame address

Linda Hungerford, MD

Internal Medicine

NPI 1902832363

1321 NE 99TH AVE SUITE 100
Portland, OR 97220

(503) 215-4050

✔ PECOS✔ Accepts MedicareSame address

Kristin Kocher, MD

Family Practice

NPI 1629004155

1321 NE 99TH AVE SUITE 200
Portland, OR 97220

(503) 215-6446

✔ PECOS✔ Accepts MedicareSame address

Barbara Lang, MD

Family Practice

NPI 1568491926

1321 NE 99TH AVE SUITE 200
Portland, OR 97220

(503) 215-4250

✔ PECOS✔ Accepts MedicareSame address

Brian Little, D.O.

Internal Medicine

NPI 1912987009

1321 NE 99TH AVE STE 100
Portland, OR 97220

(503) 215-4050

✔ PECOS✔ Accepts MedicareSame address

Richard Manthey, MD

Internal Medicine

NPI 1639120314

1321 NE 99TH AVE SUITE 100
Portland, OR 97220

(503) 215-9900

✔ PECOS✔ Accepts MedicareSame address

Phebe Matsen, M.D.

Family Practice

NPI 1760822290

1321 NE 99TH AVE STE 200
Portland, OR 97220

(503) 215-4250

✔ PECOS✔ Accepts MedicareSame address

Nancy Moreland, MD

Internal Medicine

NPI 1427088368

1321 NE 99TH AVE SUITE 100
Portland, OR 97220

(503) 215-9900

✔ PECOSSame address

Daniel Norfleet, M.D.

Internal Medicine

NPI 1871889741

1321 NE 99TH AVE STE 100
Portland, OR 97220

(503) 215-4050

✔ PECOS✔ Accepts MedicareSame address

Alexander Smith, PSYD

Clinical Psychologist

NPI 1891121802

1321 NE 99TH AVE STE 200
Portland, OR 97220

(503) 215-4250

✔ PECOS✔ Accepts MedicareSame address

Jaaron Smith, PSYD

Clinical Psychologist

NPI 1093184483

1321 NE 99TH AVE STE 200
Portland, OR 97220

(503) 215-4250

✔ PECOS✔ Accepts MedicareSame address

Laura Smith, PSYD

Clinical Psychologist

NPI 1386809960

1321 NE 99TH AVE STE 100
Portland, OR 97220

(503) 215-4050

✔ PECOS✔ Accepts MedicareSame address

Katherine Trumbo, DNP, APRN, FNP-C

Nurse Practitioner

NPI 1194155804

1321 NE 99TH AVE STE 100
Portland, OR 97220

(503) 215-4050

✔ PECOS✔ Accepts MedicareSame address

Nori Trevarthen, FNP

Nurse Practitioner

NPI 1881641397

1321 NE 99TH AVE STE 100
Portland, OR 97220

(503) 215-9900

✔ PECOSSame address

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 1073604955. It was assigned to this organization in the NPPES registry on September 27, 2006. The provider is doing business as Providence Medical Group and Providence Medical Group Gateway Immediate Care.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 1321 NE 99th Ave Suite 100, Portland, OR 97220. The listed phone number is (503) 215-9900.

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

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

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, 29 practice at this address and 626 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.