PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1124129903
Family Medicine in Portland, OR

Active since September 26, 2006
1321 NE 99TH AVE, SUITE 200, PORTLAND, OR 97220(503) 215-4250(503) 215-4255 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, May 16, 2025, Jun 10, 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 1124129903), doing business as Providence Medical Group, is a healthcare organization registered as a family 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

NPI1124129903
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address1321 NE 99TH AVE, SUITE 200Portland, OR 97220-9439
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6446 · Fax (503) 215-6644
Fax(503) 215-4255
Organization SubpartNo
Authorized OfficialDonald W AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateSeptember 26, 2006
Last NPPES UpdateJune 20, 20254 updates tracked since enumeration
NPPES CertifiedJune 20, 2025
✔ NPI 1124129903 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
1321 NE 99TH AVE, Portland, OR 97220

Other Names 2

Doing Business AsProvidence Medical Group
Doing Business AsProvidence Medical Group Gateway Family & Community Medicine

Other Identifiers 1

Medicaid022844OR

Accepted 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 625 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
Emergency Medicine
NPI 1457393670
1321 NE 99TH AVE STE 100
Portland, OR 97220
(503) 215-9900
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1316993801
1321 NE 99TH AVE SUITE 200
Portland, OR 97220
(503) 215-4250
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1104856285
1321 NE 99TH AVE SUITE 200
Portland, OR 97220
(503) 215-4250
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1124606975
1321 NE 99TH AVE STE 200
Portland, OR 97220
(503) 215-4250
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1427357680
1321 NE 99TH AVE STE 100
Portland, OR 97220
(503) 215-9900
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1245672286
1321 NE 99TH AVE STE 100
Portland, OR 97220
(503) 215-9900
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1548451479
1321 NE 99TH AVE SUITE 100
Portland, OR 97220
(503) 215-4050
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1902832363
1321 NE 99TH AVE SUITE 100
Portland, OR 97220
(503) 215-4050
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1629004155
1321 NE 99TH AVE SUITE 200
Portland, OR 97220
(503) 215-6446
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1568491926
1321 NE 99TH AVE SUITE 200
Portland, OR 97220
(503) 215-4250
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1912987009
1321 NE 99TH AVE STE 100
Portland, OR 97220
(503) 215-4050
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1639120314
1321 NE 99TH AVE SUITE 100
Portland, OR 97220
(503) 215-9900
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1760822290
1321 NE 99TH AVE STE 200
Portland, OR 97220
(503) 215-4250
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1427088368
1321 NE 99TH AVE SUITE 100
Portland, OR 97220
(503) 215-9900
✔ PECOSSame address
Internal Medicine
NPI 1871889741
1321 NE 99TH AVE STE 100
Portland, OR 97220
(503) 215-4050
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1891121802
1321 NE 99TH AVE STE 200
Portland, OR 97220
(503) 215-4250
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1093184483
1321 NE 99TH AVE STE 200
Portland, OR 97220
(503) 215-4250
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1386809960
1321 NE 99TH AVE STE 100
Portland, OR 97220
(503) 215-4050
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1194155804
1321 NE 99TH AVE STE 100
Portland, OR 97220
(503) 215-4050
✔ PECOS✔ Accepts MedicareSame address
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 1124129903. It was assigned to this organization in the NPPES registry on September 26, 2006. The provider is doing business as Providence Medical Group and Providence Medical Group Gateway Family & Community Medicine.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 1321 NE 99th Ave Suite 200, Portland, OR 97220. The listed phone number is (503) 215-4250.

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, 29 practice at this address and 625 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.