PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1891992624
Dermatology in Portland, OR

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

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since June 27, 2007

5330 NE GLISAN ST, SUITE 200, PORTLAND, OR 97213(503) 215-9080 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, Jun 13, 2024, Jan 22, 2016 (3 updates tracked since 2016).

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About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1891992624), doing business as Providence Medical Group, is a healthcare organization registered as a dermatology in Portland, Oregon and active in the NPI registry since June 2007. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1891992624

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address5330 NE GLISAN ST, SUITE 200Portland, OR 97213-3069

Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180

Phone(503) 215-9080

Organization SubpartNo

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

Enumeration DateJune 27, 2007

Last NPPES UpdateJuly 4, 20253 updates tracked since enumeration

NPPES CertifiedJuly 4, 2025

✔ NPI 1891992624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X

Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X

Also ListedClinic/CenterTaxonomy 261Q00000X

5330 NE GLISAN ST, Portland, OR 97213

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Other Names 2

Doing Business AsProvidence Medical Group

Doing Business AsProvidence Medical Group Dermatologic Specialties

Other Identifiers 1

Medicaid006508OR

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, 14 practice at this address and 1,048 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

Erin Allen, MD

Dermatology

NPI 1346344611

5330 NE GLISAN ST STE 200
Portland, OR 97213

(503) 215-9083

✔ PECOS✔ Accepts MedicareSame address

Staci Eskesen, MD

Family Practice

NPI 1689629628

5330 NE GLISAN ST SUITE 100
Portland, OR 97213

(503) 215-9700

✔ PECOS✔ Accepts MedicareSame address

Rachel Graves, M.D.

Family Practice

NPI 1659570190

5330 NE GLISAN ST STE 100
Portland, OR 97213

(503) 215-9700

✔ PECOS✔ Accepts MedicareSame address

Rebecca Lee, FNP

Nurse Practitioner

NPI 1669198446

5330 NE GLISAN ST STE 100
Portland, OR 97213

(503) 215-9700

✔ PECOS✔ Accepts MedicareSame address

Tricia Lind, FNP

Nurse Practitioner

NPI 1891559472

5330 NE GLISAN ST STE 100
Portland, OR 97213

(503) 215-9700

✔ PECOS✔ Accepts MedicareSame address

Joseph Obadiah, M.D.

Dermatology

NPI 1699818120

5330 NE GLISAN ST SUITE 200
Portland, OR 97213

(503) 215-9080

✔ PECOS✔ Accepts MedicareSame address

Caroline Reay, MD

Internal Medicine

NPI 1447283205

5330 NE GLISAN ST SUITE 100
Portland, OR 97213

(503) 215-9700

✔ PECOSSame address

Andrew Tobler, DO

Family Practice

NPI 1548842438

5330 NE GLISAN ST STE 100
Portland, OR 97213

(503) 215-9700

✔ PECOS✔ Accepts MedicareSame address

Charles White, M.D.

Family Practice

NPI 1740485432

5330 NE GLISAN ST STE 100
Portland, OR 97213

(503) 215-9700

✔ PECOS✔ Accepts MedicareSame address

Taylor Krieg, DO

Internal Medicine

NPI 1326400573

5330 NE GLISAN ST STE 100
Portland, OR 97213

(503) 215-9700

✔ PECOS✔ Accepts MedicareSame address

Margaret Black, M.D.

Family Practice

NPI 1659699528

5330 NE GLISAN ST STE 100
Portland, OR 97213

(503) 215-9700

✔ PECOS✔ Accepts MedicareSame address

Brian Becker Broncheau, M.D.

Psychiatry

NPI 1821226713

5251 NE GLISAN ST BLDG A, 2ND FLOOR
Portland, OR 97213

(503) 215-4860

✔ PECOS✔ Accepts MedicareSame address

Palaniappan Chidambaram, M.D.

Addiction Medicine

NPI 1770651200

5251 NE GLISAN ST BLDG A, 2ND FLOOR
Portland, OR 97213

(503) 215-4860

✔ PECOS✔ Accepts MedicareSame address

Sharon Hammond, PMHNP

Nurse Practitioner

NPI 1821009606

5251 NE GLISAN ST BLDG A, 2ND FLOOR
Portland, OR 97213

(503) 215-6285

✔ PECOS✔ Accepts MedicareSame address

Daniel Fischer, M.D.

Psychiatry

NPI 1275875189

5228 NE HOYT ST BLDG B, STE 300
Portland, OR 97213

(503) 215-4860

✔ PECOS✔ Accepts Medicare0.1 mi

Annika Ginsberg, LCSW, R.D., L.D

Clinical Social Worker

NPI 1235406018

5228 NE HOYT ST BLDG B
Portland, OR 97213

(503) 215-1518

✔ PECOS0.1 mi

Katie Mcculloch, PH.D.

Clinical Psychologist

NPI 1013454842

5228 NE HOYT ST BLDG B2ND
Portland, OR 97213

(503) 215-4860

✔ PECOS✔ Accepts Medicare0.1 mi

Mary Beckman, LPC

Mental Health Counselor

NPI 1851659759

5228 NE HOYT ST BLDG B3
Portland, OR 97213

(503) 215-4860

✔ PECOS✔ Accepts Medicare0.1 mi

Jade Bergez, PMHNP

Nurse Practitioner

NPI 1174038277

5228 NE HOYT ST BLDG B
Portland, OR 97213

(503) 215-4860

✔ PECOS✔ Accepts Medicare0.1 mi

Christopher Schraner, RD

Registered Dietitian or Nutrition Professional

NPI 1578959466

5211 NE GLISAN ST BLDG C
Portland, OR 97213

(503) 893-6647

✔ Accepts Medicare0.1 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 1891992624. It was assigned to this organization in the NPPES registry on June 27, 2007. The provider is doing business as Providence Medical Group and Providence Medical Group Dermatologic Specialties.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 5330 NE Glisan St Suite 200, Portland, OR 97213. The listed phone number is (503) 215-9080.

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

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

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, 14 practice at this address and 1,048 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.