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JACOB LYTHGOE
NPI 1164041620
Radiology - Diagnostic Radiology in Portland, OR

Active since April 14, 2020PECOS EnrolledAccepts Medicare Assignment
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 418-0990 Get Directions Write a Review

NPPES record last updated: June 18, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 18, 2025, Apr 14, 2020 (2 updates tracked since 2020).

About Jacob Lythgoe NPPES

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

JACOB LYTHGOE (NPI 1164041620) is an individual diagnostic radiology provider in Portland, Oregon, licensed in Oregon (MD224317) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS and is a graduate of University Of Arizona College Of Medicine - Phoenix (2020).

NPPES Registry Identity

NPI1164041620
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameJACOB LYTHGOE
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011
Mailing Address3181 Sw Sam Jackson Park RdPortland, OR 97239-3011 · (503) 418-0990
Phone(503) 418-0990
Sole ProprietorNo
Medical School CMSUniversity Of Arizona College Of Medicine - PhoenixGraduated 2020
Enumeration DateApril 14, 2020
Last NPPES UpdateJune 18, 20252 updates tracked since enumeration
NPPES CertifiedJune 18, 2025
✔ NPI 1164041620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in OR · MD224317
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3181 SW SAM JACKSON PARK RD, Portland, OR 97239
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob Lythgoe is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3375946189
PECOS Enrollment IDI20250701004577
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97239 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DONALD RICHARD SULLIVAN MD
Internal Medicine (Pulmonary Disease)
3181 SW SAM JACKSON PARK RD, UHN67
PORTLAND, OR 97239
Multnomah County (503) 494-6949
MRS. ANJALEE NIX ROWE NP
Nurse Practitioner (Acute Care)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-3988
REEM HASAN MD
Internal Medicine
3181 SW SAM JACKSON PARK RD, PPV 350
PORTLAND, OR 97239
Multnomah County (503) 494-8562
DR. AMANDA D BALL PSY.D
Psychologist (Clinical)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
SUNSHINE WELSCH LMT
Massage Therapist
3181 SW SAM JACKSON PARK RD, 7D19
PORTLAND, OR 97239
Multnomah County (503) 494-8349
DR. ROBERT GENE MEALER M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
GREGORY HALL MD
Radiology (Diagnostic Radiology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 418-0990
DR. BURHAN AHMED MIAN MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-8311

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 Jacob Lythgoe's NPI number?

The NPI number for Jacob Lythgoe is 1164041620. It was assigned to this individual provider in the NPPES registry on April 14, 2020.

Where is Jacob Lythgoe located?

Jacob Lythgoe practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 418-0990.

What is Jacob Lythgoe's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Jacob Lythgoe enrolled in Medicare?

Yes. Jacob Lythgoe is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jacob Lythgoe was last updated on June 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.