PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1336311554
Psychiatry & Neurology - Neurology in Portland, OR

Active since March 27, 2008
4805 NE GLISAN ST, SUITE 6N50, PORTLAND, OR 97213(503) 216-1150(503) 216-1066 Get Directions Write a Review

NPPES record last updated: July 4, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 4, 2025, May 16, 2025 (2 updates tracked since 2025).

About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1336311554), doing business as Providence Medical Group, is a healthcare organization registered as a neurology in Portland, Oregon and active in the NPI registry since March 2008. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1336311554
Entity TypeOrganization
Primary Taxonomy2084N0400X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address4805 NE GLISAN ST, SUITE 6N50Portland, OR 97213-2933
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180
Fax(503) 216-1066
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary Enrollment · (425) 358-9786
Enumeration DateMarch 27, 2008
Last NPPES UpdateJuly 4, 20252 updates tracked since enumeration
NPPES CertifiedJuly 4, 2025
✔ NPI 1336311554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
4805 NE GLISAN ST, Portland, OR 97213

Other Names 2

Doing Business AsProvidence Medical Group
Doing Business AsProvidence Neurological Specialties Ppmc

Other Identifiers 1

Medicaid279129OR

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, 136 practice at this address and 1,050 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
Nurse Practitioner
NPI 1053955047
4805 NE GLISAN ST
Portland, OR 97213
(503) 215-2392
✔ PECOS✔ Accepts MedicareSame address
Hospitalist
NPI 1942246947
4805 NE GLISAN ST SUITE BG05
Portland, OR 97213
(503) 215-2392
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1760006118
4805 NE GLISAN ST
Portland, OR 97213
(503) 215-2392
✔ PECOS✔ Accepts MedicareSame address
Emergency Medicine
NPI 1689094583
4805 NE GLISAN ST
Portland, OR 97213
(503) 215-1111
✔ PECOS✔ Accepts MedicareSame address
Gynecological Oncology
NPI 1609130392
4805 NE GLISAN ST STE 11N
Portland, OR 97213
(503) 215-2075
✔ PECOS✔ Accepts MedicareSame address
Endocrinology
NPI 1083653679
4805 NE GLISAN ST STE 6N40
Portland, OR 97213
(503) 215-6601
✔ PECOS✔ Accepts MedicareSame address
Medical Oncology
NPI 1841460193
4805 NE GLISAN ST STE 6N50
Portland, OR 97213
(503) 215-5696
✔ PECOS✔ Accepts MedicareSame address
Surgical Oncology
NPI 1336415140
4805 NE GLISAN ST STE 11N
Portland, OR 97213
(503) 215-8650
✔ PECOS✔ Accepts MedicareSame address
Registered Dietitian or Nutrition Professional
NPI 1972075687
4805 NE GLISAN ST STE 6N40
Portland, OR 97213
(253) 569-1239
Same address
General Surgery
NPI 1245587823
4805 NE GLISAN ST STE 6N60
Portland, OR 97213
(503) 935-8379
✔ PECOS✔ Accepts MedicareSame address
Psychiatry
NPI 1467030932
4805 NE GLISAN ST
Portland, OR 97213
(503) 215-6199
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1235574955
4805 NE GLISAN ST
Portland, OR 97213
(503) 215-4860
✔ PECOS✔ Accepts MedicareSame address
Dentist
NPI 1710730601
4805 NE GLISAN ST STE 11N
Portland, OR 97213
(503) 215-1676
✔ PECOS✔ Accepts MedicareSame address
Oral Medicinist
NPI 1063655967
4805 NE GLISAN ST STE 11N
Portland, OR 97213
(503) 215-1676
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1942634134
4805 NE GLISAN ST STE 6N40
Portland, OR 97213
(503) 215-7230
✔ PECOS✔ Accepts MedicareSame address
Hematology/Oncology
NPI 1689871535
4805 NE GLISAN ST SUITE 6N40
Portland, OR 97213
(503) 215-5696
✔ PECOS✔ Accepts MedicareSame address
Thoracic Surgery
NPI 1538278700
4805 NE GLISAN ST STE 6N50
Portland, OR 97213
(503) 215-2300
✔ PECOS✔ Accepts MedicareSame address
Obstetrics/Gynecology
NPI 1083844765
4805 NE GLISAN ST UNIT 3K
Portland, OR 97213
(503) 215-6150
✔ PECOS✔ Accepts MedicareSame address
Orofacial Pain
NPI 1477786499
4805 NE GLISAN ST STE 11N
Portland, OR 97213
(503) 215-1676
✔ PECOS✔ Accepts MedicareSame address
Colorectal Surgery (Proctology)
NPI 1710970892
4805 NE GLISAN ST SUITE 6N60
Portland, OR 97213
(503) 281-0561
✔ PECOS✔ Accepts MedicareSame 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 1336311554. It was assigned to this organization in the NPPES registry on March 27, 2008. The provider is doing business as Providence Medical Group and Providence Neurological Specialties Ppmc.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 4805 NE Glisan St Suite 6n50, Portland, OR 97213. The listed phone number is (503) 216-1150.

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

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

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, 136 practice at this address and 1,050 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 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.