PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1790113405
Nurse Practitioner in Portalnd, OR
About Providence Health & Services - Oregon NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1790113405), doing business as Providence Medical Group South, is a healthcare organization registered as a nurse practitioner in Portalnd, Oregon and active in the NPI registry since October 2013. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 2
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
1,498Medicare enrollment records show 1,498 clinicians reassign Medicare billing to Providence Health & Services - Oregon, which bills Medicare for the services they deliver. Of these, 28 practice at this address and 1,046 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 56
Nearest to this location (20)
See all 1,498Portland, OR 97213
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 1790113405. It was assigned to this organization in the NPPES registry on October 16, 2013. The provider is doing business as Providence Medical Group South and Providence Health eXpress BP.
Where is Providence Health & Services - Oregon located?
Providence Health & Services - Oregon is located at 4400 NE Halsey Bldg 2 3rd Flr, Portalnd, OR 97213. The listed phone number is (855) 229-6460.
What is Providence Health & Services - Oregon's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
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, 28 practice at this address and 1,046 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 March 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Providence Health & Services - Oregon · NPI 1790113405
Nurse Practitioner organization in Portalnd, Oregon. Organization record, active in the CMS NPPES registry since October 16, 2013.
## Identity
- **NPI:** 1790113405 (Entity type: Organization)
- **Enumerated:** October 16, 2013
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **Also known as:** PROVIDENCE MEDICAL GROUP SOUTH (Doing Business As); Providence Health eXpress BP (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Donald Anderson, ASSISTANT SECRETARY ENROLLMENT
## Practice location
- **Address:** 4400 NE HALSEY, BLDG 2 3RD FLR, Portalnd, OR 97213
- **Phone:** (855) 229-6460 · **Fax:** (503) 216-0710
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1,498 clinicians in 56 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (250), Family Practice (212), Nurse Practitioner (210); 28 practice at this address and 1,046 within 10 miles; [full list](https://npiprofile.com/npi/1790113405/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 25, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1790113405) · Data from the CMS NPPES public registry.