PROVIDENCE HEALTH & SERVICES OREGON
NPI 1164623401
Internal Medicine in Portland, OR

Q: What is Providence Health & Services Oregon's NPI number?

The NPI number for Providence Health & Services Oregon is 1164623401. It was assigned to this organization in the NPPES registry on May 31, 2007. The provider is doing business as Providence Medical Group.

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 May 31, 2007

4400 NE HALSEY ST, PORTLAND, OR 97213(503) 893-6524 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 16, 2025, Oct 14, 2022 and 2 more (5 updates tracked since 2017).

On this page

About Providence Health & Services Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES OREGON (NPI 1164623401), 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 May 2007. The organization lists Donald Wayne Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1164623401

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES OREGON

Location Address4400 NE HALSEY STPortland, OR 97213-1545

Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180

Phone(503) 893-6524

Organization SubpartNo

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

Enumeration DateMay 31, 2007

Last NPPES UpdateJune 20, 20255 updates tracked since enumeration

NPPES CertifiedJune 20, 2025

✔ NPI 1164623401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 ListedSocial WorkerTaxonomy 104100000X

Also ListedClinic/CenterTaxonomy 261Q00000X

4400 NE HALSEY ST, Portland, OR 97213

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Other Names 1

Doing Business AsProvidence Medical Group

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, revalidation 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).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateTexasEnrollment IDO20210920001288Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

1,614

Medicare enrollment records show 1,614 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 1,049 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 57

Internal Medicine261

Family Practice214

Nurse Practitioner211

Neurology111

Hospitalist108

Psychiatry58

Obstetrics/Gynecology57

Physical Therapist in Private Practice54

49 other specialties540

Nearest to this location (20)

See all 1,614

Jason Bensch, M.D.

Cardiovascular Disease (Cardiology)

NPI 1164765111

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Sarah Bereznai, NP

Nurse Practitioner

NPI 1679086938

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Lisa Enger, ANP

Nurse Practitioner

NPI 1295983617

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Benjamin Hartwig, AGACNP

Nurse Practitioner

NPI 1578008397

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Anna Hemphill, MD

Family Practice

NPI 1942591813

4400 NE HALSEY ST
Portland, OR 97213

(503) 215-0750

✔ PECOS✔ Accepts MedicareSame address

Dale Hirsch, MD

Cardiovascular Disease (Cardiology)

NPI 1114919610

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Kimberly Hsu, M.D.

Cardiovascular Disease (Cardiology)

NPI 1902425945

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOSSame address

Xiaoyan Huang, MD

Cardiovascular Disease (Cardiology)

NPI 1346232857

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Claire Learmonth, MD

Obstetrics/Gynecology

NPI 1720583727

4400 NE HALSEY ST STE 285
Portland, OR 97213

(503) 215-6262

✔ PECOS✔ Accepts MedicareSame address

Jacqueline Levene, DO

Internal Medicine

NPI 1043673866

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Robert Litt, M.D.

Cardiovascular Disease (Cardiology)

NPI 1467444331

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Megan Monty, FNP

Nurse Practitioner

NPI 1952645392

4400 NE HALSEY ST STE 286
Portland, OR 97213

(503) 729-5814

✔ PECOS✔ Accepts MedicareSame address

Jessica Nicoud

Registered Dietitian or Nutrition Professional

NPI 1295378545

4400 NE HALSEY ST BLDG 2
Portland, OR 97213

(503) 893-7146

✔ Accepts MedicareSame address

Christina O'guinn, FNP

Nurse Practitioner

NPI 1265048151

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Alefiyah Rajabali, MD

Cardiac Electrophysiology

NPI 1386925899

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Nicole Ransbottom, AGACNP

Nurse Practitioner

NPI 1255065330

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Aaron Schoenkerman, MD

Cardiovascular Disease (Cardiology)

NPI 1487748836

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Alexi Zemsky, MD

Cardiac Electrophysiology

NPI 1598944928

4400 NE HALSEY ST STE 102
Portland, OR 97213

(503) 962-1000

✔ PECOS✔ Accepts MedicareSame address

Chang Lee, MD

Internal Medicine

NPI 1962066100

4400 NE HALSEY ST, BLDG 2 3RD FLOOR
Portland, OR 97213

(503) 215-0750

✔ PECOS✔ Accepts MedicareSame address

Mary Walker, CNM

Certified Nurse Midwife (CNM)

NPI 1639730666

4400 NE HALSEY ST STE 285
Portland, OR 97213

(503) 215-6262

✔ PECOS✔ Accepts MedicareSame address

See all 1,614 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 1164623401. It was assigned to this organization in the NPPES registry on May 31, 2007. The provider is doing business as Providence Medical Group.

Where is Providence Health & Services Oregon located?

Providence Health & Services Oregon is located at 4400 NE Halsey St, Portland, OR 97213. The listed phone number is (503) 893-6524.

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.

When is Providence Health & Services Oregon's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Texas, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Providence Health & Services Oregon?

According to the CMS Revalidation Reassignment List (October 2026 release), 1,614 clinicians in 57 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 (261), Family Practice (214) and Nurse Practitioner (211). Of these, 29 practice at this address and 1,049 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.