PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1083714141
Dermatology in Portland, OR

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

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since September 25, 2006

417 SW 117TH AVE, 2ND FLOOR, PORTLAND, OR 97225(503) 216-9400(503) 216-9499 Get Directions Write a Review

NPPES record last updated: June 20, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 20, 2025, May 5, 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 1083714141), doing business as Providence Medical Group, is a healthcare organization registered as a dermatology in Portland, Oregon and active in the NPI registry since September 2006. The organization lists Donald W Anderson, Asst Sec Enroll, as its authorized official.

NPPES Registry Identity

NPI1083714141

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address417 SW 117TH AVE, 2ND FLOORPortland, OR 97225-5924

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

Phone(503) 216-9400

Fax(503) 216-9499

Organization SubpartNo

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

Enumeration DateSeptember 25, 2006

Last NPPES UpdateJune 20, 20253 updates tracked since enumeration

NPPES CertifiedJune 20, 2025

✔ NPI 1083714141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedClinic/CenterTaxonomy 261Q00000X

417 SW 117TH AVE, Portland, OR 97225

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Other Names 2

Doing Business AsProvidence Medical Group

Doing Business AsProvidence Medical Group Sunset

Other Identifiers 1

Medicaid065003OR

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, 17 practice at this address and 1,061 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

Meenakshi Vanka, MD

Internal Medicine

NPI 1033868120

417 SW 117TH AVE STE 200
Portland, OR 97225

(503) 216-9400

✔ PECOS✔ Accepts MedicareSame address

Michelle Bonta, MD

Dermatology

NPI 1265468615

417 SW 117TH AVE 2ND FLOOR
Portland, OR 97225

(503) 216-9400

✔ PECOS✔ Accepts MedicareSame address

Richard Cam, DO

Internal Medicine

NPI 1316438468

417 SW 117TH AVE STE 200
Portland, OR 97225

(503) 216-9400

✔ PECOS✔ Accepts MedicareSame address

Timothy Duh, MD

Internal Medicine

NPI 1528625878

417 SW 117TH AVE STE 200
Portland, OR 97225

(503) 216-9400

✔ PECOS✔ Accepts MedicareSame address

Reza Kafi, MD

Dermatology

NPI 1891737201

417 SW 117TH AVE STE 100
Portland, OR 97225

(503) 216-8980

✔ PECOS✔ Accepts MedicareSame address

Jean Lee, MD

Internal Medicine

NPI 1346450319

417 SW 117TH AVE 2ND FLOOR
Portland, OR 97225

(503) 216-9400

✔ PECOS✔ Accepts MedicareSame address

Megan Mudrick, MD

Family Practice

NPI 1528250131

417 SW 117TH AVE SUITE 100
Portland, OR 97225

(503) 216-1800

✔ PECOS✔ Accepts MedicareSame address

Jeffrey Sun, DO

Family Practice

NPI 1457743296

417 SW 117TH AVE STE 200
Portland, OR 97225

(503) 216-1800

✔ PECOS✔ Accepts MedicareSame address

Richard Tsai, MD

Internal Medicine

NPI 1558387555

417 SW 117TH AVE 2ND FLOOR
Portland, OR 97225

(503) 216-9400

✔ PECOS✔ Accepts MedicareSame address

Lisa Turner, MD

Dermatology

NPI 1093731093

417 SW 117TH AVE 2ND FLOOR
Portland, OR 97225

(503) 216-9400

✔ PECOS✔ Accepts MedicareSame address

Gefei Zhu, M.D.

Dermatology

NPI 1518329804

417 SW 117TH AVE STE 100
Portland, OR 97225

(503) 216-8980

✔ PECOS✔ Accepts MedicareSame address

Ellen Priscilla Bautista Yang, MD

Family Practice

NPI 1174744395

417 SW 117TH AVE STE 200
Portland, OR 97225

(503) 216-2800

✔ PECOS✔ Accepts MedicareSame address

Andrew Elton, MD

Internal Medicine

NPI 1164167557

417 SW 117TH AVE STE 200
Portland, OR 97225

(503) 216-9400

✔ PECOSSame address

Andrew Barnes, PH.D

Clinical Psychologist

NPI 1295979805

417 SW 117TH AVE STE 200
Portland, OR 97225

(503) 216-1800

✔ PECOS✔ Accepts MedicareSame address

Amy Frankel, M.D.

Dermatology

NPI 1427293208

417 SW 117TH AVE STE 100
Portland, OR 97225

(503) 216-8980

✔ PECOS✔ Accepts MedicareSame address

Luis Scheker, MD

Dermatology

NPI 1740293158

417 SW 117TH AVE SUITE 210
Portland, OR 97225

(503) 216-9400

✔ PECOS✔ Accepts MedicareSame address

Kristin Stevens, MD

Dermatology

NPI 1689690737

417 SW 117TH AVE SUITE 210
Portland, OR 97225

(503) 216-9400

✔ PECOS✔ Accepts MedicareSame address

Hans Moller, M.D.

Orthopedic Surgery

NPI 1831113133

11782 SW BARNES RD STE 300
Portland, OR 97225

(503) 214-5200

✔ PECOS✔ Accepts Medicare0.1 mi

Kathy Bak, M.D.

Family Practice

NPI 1861412884

12400 NW CORNELL RD STE 100
Portland, OR 97229

(503) 291-4000

✔ PECOS✔ Accepts Medicare0.7 mi

Elizabeth Beswick, PSYD

Clinical Psychologist

NPI 1356550362

12400 NW CORNELL RD STE 100
Portland, OR 97229

(503) 291-4000

✔ PECOS✔ Accepts Medicare0.7 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 1083714141. 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 Sunset.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 417 SW 117th Ave 2nd Floor, Portland, OR 97225. The listed phone number is (503) 216-9400.

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

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

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, 17 practice at this address and 1,061 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.