LYLE JAMES FAGNAN MD
NPI 1669487161
Family Medicine in Portland, OR

Q: What is Lyle Fagnan's NPI number?

The NPI number for Lyle Fagnan is 1669487161. It was assigned to this individual provider in the NPPES registry on July 31, 2006.

Q: What is Lyle Fagnan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Lyle Fagnan was last updated on July 13, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.

Active since July 31, 2006PECOS Enrolled

4411 SW VERMONT ST, PORTLAND, OR 97219(503) 494-9992 Get Directions Write a Review

NPPES record last updated: July 13, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Lyle James Fagnan Md NPPES

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

LYLE JAMES FAGNAN MD (NPI 1669487161) is an individual family medicine provider in Portland, Oregon, licensed in Oregon (MD10673) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669487161

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameLYLE JAMES FAGNANCredential: MD

Location Address4411 SW VERMONT STPortland, OR 97219-1020

Mailing Address3181 Sw Sam Jackson Park Rd, L222Portland, OR 97239-3011 · (503) 494-1582 · Fax (503) 494-1513

Phone(503) 494-9992

Sole ProprietorNo

Enumeration DateJuly 31, 2006

Last NPPES UpdateJuly 13, 2007

✔ NPI 1669487161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OR · MD10673

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.

4411 SW VERMONT ST, Portland, OR 97219

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Other Identifiers 2

Medicaid235119OR

Medicare UPINC91006

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lyle James Fagnan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 97219 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

$103.51 typical visit price

range $19.32 – $144.79

Typical copayment $25.87 (range $4.83 – $36.19)

Most-billed visit code 99214

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.

SARAH KUPPENBENDER KONG FNP-C

Nurse Practitioner (Family)

4411 SW VERMONT ST
PORTLAND, OR 97219

Multnomah County (503) 494-9992

UNIVERSITY PROFESSIONAL SERVICES

General Practice

4411 SW VERMONT ST
PORTLAND, OR 97219

Multnomah County (503) 494-9992

SHERILYN M DESTEFANO MD

Family Medicine

4411 SW VERMONT ST
PORTLAND, OR 97219

Multnomah County (503) 494-9992

ELIZABETH STEINER HAYWARD MD

Family Medicine

4411 SW VERMONT ST, OHSU GABRIEL PARK FAMILY HEALTH CENTER
PORTLAND, OR 97219

Multnomah County (503) 494-1900

JAN HAXBY RPH

Pharmacist

4411 SW VERMONT ST
PORTLAND, OR 97219

Multnomah County (503) 494-2098

MS. CLAIRE E. HULL PA-C

Physician Assistant

4411 SW VERMONT ST
PORTLAND, OR 97219

Multnomah County (503) 494-9992

THEA J DENNIS-ARENDS MD

Family Medicine

4411 SW VERMONT ST
PORTLAND, OR 97219

Multnomah County (503) 494-9992

FRANKLYN DAVID DORNFEST MD

Family Medicine

4411 SW VERMONT ST
PORTLAND, OR 97219

Multnomah County (503) 494-9992

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 Lyle Fagnan's NPI number?

The NPI number for Lyle Fagnan is 1669487161. It was assigned to this individual provider in the NPPES registry on July 31, 2006.

Where is Lyle Fagnan located?

Lyle Fagnan practices at 4411 SW Vermont St, Portland, OR 97219. The listed phone number is (503) 494-9992.

What is Lyle Fagnan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Lyle Fagnan enrolled in Medicare?

Yes. Lyle Fagnan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lyle Fagnan was last updated on July 13, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.