PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1235479643
Internal Medicine - Sports Medicine in Portland, OR

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

The primary specialty registered for this NPI is Internal Medicine, specializing in Sports Medicine, with taxonomy code 207RS0010X.

Active since February 21, 2013

909 SW 18TH AVE, PORTLAND, OR 97205(503) 962-1946(503) 962-1925 Get Directions Write a Review

NPPES record last updated: July 4, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 4, 2025, May 16, 2025, Aug 20, 2021 (3 updates tracked since 2021).

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 1235479643), doing business as Providence Medical Group, is a healthcare organization registered as a sports medicine in Portland, Oregon and active in the NPI registry since February 2013. The organization lists Donald Wayne Anderson, Assistant Secreatry For Enrollment, as its authorized official.

NPPES Registry Identity

NPI1235479643

Entity TypeOrganization

Primary Taxonomy207RS0010X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address909 SW 18TH AVEPortland, OR 97205-1705

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

Phone(503) 962-1946

Fax(503) 962-1925

Organization SubpartNo

Authorized OfficialDonald Wayne AndersonAssistant Secreatry For Enrollment · (425) 358-9786

Enumeration DateFebruary 21, 2013

Last NPPES UpdateJuly 4, 20253 updates tracked since enumeration

NPPES CertifiedJuly 4, 2025

✔ NPI 1235479643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RS0010X

Definition

An internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual.

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedClinic/CenterTaxonomy 261Q00000X

909 SW 18TH AVE, Portland, OR 97205

Open in Google Maps ↗

Other Names 2

Doing Business AsProvidence Medical Group

Doing Business AsProvidence Medical Group Sports Care

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

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, 1,111 practice 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

Evan Alldredge, MD

Anesthesiology

NPI 1194276931

707 SW WASHINGTON ST STE 700
Portland, OR 97205

(503) 299-9906

✔ PECOS✔ Accepts Medicare0.6 mi

Tessa Collins, MD

Anesthesiology

NPI 1821009556

707 SW WASHINGTON ST STE 700
Portland, OR 97205

(503) 299-9906

✔ PECOS0.6 mi

Matthew Doran

Anesthesiology

NPI 1609070770

707 SW WASHINGTON ST SUITE 700
Portland, OR 97205

(503) 299-9906

✔ PECOS✔ Accepts Medicare0.6 mi

Stephen Holmes, MD

Anesthesiology

NPI 1952366775

707 SW WASHINGTON ST SUITE 700
Portland, OR 97205

(503) 299-9906

✔ PECOS✔ Accepts Medicare0.6 mi

Jan-Pablo Kollmar, MD

Anesthesiology

NPI 1073923249

707 SW WASHINGTON ST STE 700
Portland, OR 97205

(503) 299-9906

✔ PECOS✔ Accepts Medicare0.6 mi

Andrea Orfanakis, MD

Anesthesiology

NPI 1861549669

707 SW WASHINGTON ST SUITE 700
Portland, OR 97205

(503) 299-9906

✔ PECOS✔ Accepts Medicare0.6 mi

Thomas Phillips, DO

Anesthesiology

NPI 1548624232

707 SW WASHINGTON ST STE 700
Portland, OR 97205

(503) 299-9906

✔ PECOS✔ Accepts Medicare0.6 mi

Richard Shih, M.D.

Anesthesiology

NPI 1083803704

707 SW WASHINGTON ST SUITE 700
Portland, OR 97205

(503) 299-9906

✔ PECOS✔ Accepts Medicare0.6 mi

Ari Tallen, M.D.

Anesthesiology

NPI 1306286133

707 SW WASHINGTON ST STE 700
Portland, OR 97205

(503) 299-9906

✔ PECOS✔ Accepts Medicare0.6 mi

Jon Lucaj, MD

Anesthesiology

NPI 1922591296

707 SW WASHINGTON ST STE 700
Portland, OR 97205

(503) 299-9906

✔ PECOS✔ Accepts Medicare0.6 mi

Allen Cheng, MD, DDS

Maxillofacial Surgery

NPI 1043537707

1849 NW KEARNEY ST SUITE 300
Portland, OR 97209

(503) 224-1371

✔ PECOS0.6 mi

Ashish Patel, MD, DDS,FACS

Maxillofacial Surgery

NPI 1043415870

1849 NW KEARNEY ST SUITE 300
Portland, OR 97209

(503) 224-1371

✔ PECOS0.6 mi

Kristen Waits, FNP

Nurse Practitioner

NPI 1790838076

2050 NW LOVEJOY ST. STE 1
Portland, OR 97209

(503) 227-0350

✔ PECOS0.6 mi

Kendra Watson, FNP

Nurse Practitioner

NPI 1760637920

1420 NW LOVEJOY ST #432
Portland, OR 97209

(503) 914-6125

✔ PECOS0.7 mi

Carol Suzuki, MD

Obstetrics/Gynecology

NPI 1427068410

1040 NW 22ND AVE STE 330
Portland, OR 97210

(503) 274-9936

✔ PECOS✔ Accepts Medicare0.7 mi

Sabrina Drexel, MD

General Surgery

NPI 1477971117

1040 NW 22ND AVE STE 470
Portland, OR 97210

(503) 914-0024

✔ PECOS✔ Accepts Medicare0.7 mi

Gina Westhoff, MD

Gynecological Oncology

NPI 1598927261

1130 NW 22ND AVE SUITE 110
Portland, OR 97210

(503) 413-8654

✔ PECOS✔ Accepts Medicare0.7 mi

James Gendreau, MD

Internal Medicine

NPI 1265056626

1130 NW 22ND AVENUE, STE 640
Portland, OR 97210

(503) 229-7976

✔ PECOS✔ Accepts Medicare0.8 mi

Haley Parson, FNP

Nurse Practitioner

NPI 1104507946

1130 NW 22ND AVE STE LL10
Portland, OR 97210

(503) 413-6050

✔ PECOS✔ Accepts Medicare0.8 mi

Qian Leng, MD

Internal Medicine

NPI 1154637015

421 SW OAK ST STE. 210
Portland, OR 97204

(503) 988-7468

✔ PECOS✔ Accepts Medicare0.8 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 1235479643. It was assigned to this organization in the NPPES registry on February 21, 2013. The provider is doing business as Providence Medical Group and Providence Medical Group Sports Care.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 909 SW 18th Ave, Portland, OR 97205. The listed phone number is (503) 962-1946.

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

The primary specialty registered for this NPI is Internal Medicine, specializing in Sports Medicine, with taxonomy code 207RS0010X.

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, 1,111 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 15 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.