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PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1205937273
Family Medicine in Lake Oswego, OR

Active since September 25, 2006
4004 KRUSE WAY PL STE 300, LAKE OSWEGO, OR 97035(503) 216-1500 Get Directions Write a Review

NPPES record last updated: July 4, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 4, 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 1205937273), doing business as Providence Medical Group, is a healthcare organization registered as a family medicine in Lake Oswego, Oregon and active in the NPI registry since September 2006. The organization lists Donald Wayne Anderson, Assistant Secreatry For Enrollment, as its authorized official.

NPPES Registry Identity

NPI1205937273
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address4004 KRUSE WAY PL STE 300Lake Oswego, OR 97035-2479
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6494 · Fax (503) 215-6644
Phone(503) 216-1500
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secreatry For Enrollment · (425) 358-9786
Enumeration DateSeptember 25, 2006
Last NPPES UpdateJuly 4, 20254 updates tracked since enumeration
NPPES CertifiedJuly 4, 2025
✔ NPI 1205937273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 ListedPhysical TherapistTaxonomy 225100000X
Also ListedClinic/CenterTaxonomy 261Q00000X
4004 KRUSE WAY PL STE 300, Lake Oswego, OR 97035
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Other Names 2

Doing Business AsProvidence Medical Group
Doing Business AsProvidence Medical Group Mercantile

Other Identifiers 1

Medicaid241291OR

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 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 1,077 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
Tony Huynh, PT
Physical Therapist in Private Practice
NPI 1336952480
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1712
✔ Accepts MedicareSame address
Rachel Jones, PSYD
Clinical Psychologist
NPI 1003080284
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts MedicareSame address
Amalia Pfeifer, PT
Physical Therapist in Private Practice
NPI 1194356311
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1712
✔ Accepts MedicareSame address
Eric Wecker, MD
Family Practice
NPI 1609396365
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts MedicareSame address
Stephanie Barayuga, MD
Internal Medicine
NPI 1295225951
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts MedicareSame address
Olesea Bonanno, ARNP
Nurse Practitioner
NPI 1386128056
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts MedicareSame address
Colleen Finnegan, M.D.
Internal Medicine
NPI 1104909936
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts MedicareSame address
Laura Gaff, M.D.
Family Practice
NPI 1033401906
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts MedicareSame address
Olivia Kamayangi, M.D.
Family Practice
NPI 1437312766
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts MedicareSame address
Sayali Kulkarni, FNP
Nurse Practitioner
NPI 1821647140
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts MedicareSame address
Katrine Kwiatkowski, PT, DPT
Physical Therapist in Private Practice
NPI 1588194179
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ Accepts MedicareSame address
Christopher Mikulic, PSYD
Clinical Psychologist
NPI 1548759418
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts MedicareSame address
Ramey Volk, PT, DPT, CLT, CCI
Physical Therapist in Private Practice
NPI 1790312353
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1712
Same address
Hannah Lundeen, RD
Registered Dietitian or Nutrition Professional
NPI 1043996317
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ Accepts MedicareSame address
Kim Waarvick, MD
Family Practice
NPI 1972527968
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts MedicareSame address
Eric Falquist, PT
Physical Therapist in Private Practice
NPI 1841681491
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1712
✔ Accepts MedicareSame address
Claire Higgins, MD
Internal Medicine
NPI 1992453302
4004 KRUSE WAY PL STE 300
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts MedicareSame address
Mary Brown, FNP
Nurse Practitioner
NPI 1285832360
4015 MERCANTILE DR STE 200
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts Medicare0.1 mi
Kristina Rashid, MD
Family Practice
NPI 1417980335
4015 MERCANTILE DR SUITE 200
Lake Oswego, OR 97035
(503) 216-1500
✔ PECOS✔ Accepts Medicare0.1 mi
Mark Hastings, D.P.M.
Podiatry
NPI 1073609640
16316 BRYANT RD
Lake Oswego, OR 97035
(503) 699-8220
✔ 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 1205937273. 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 Mercantile.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 4004 Kruse Way Pl Ste 300, Lake Oswego, OR 97035. The listed phone number is (503) 216-1500.

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, 17 practice at this address and 1,077 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 July 4, 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.