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DR. JESSIE FAN MD
NPI 1932179439
Anesthesiology in Portland, OR

Active since January 25, 2006PECOS EnrolledAccepts Medicare Assignment
120 NW 14TH AVE, SUITE 300, PORTLAND, OR 97209(503) 299-9906(503) 225-9002 Get Directions Write a Review

NPPES record last updated: February 15, 2012. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Jessie Fan Md NPPES

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

DR. JESSIE FAN MD (NPI 1932179439) is an individual anesthesiology provider in Portland, Oregon, licensed in Oregon (MD27402) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS and is a graduate of Rutgers New Jersey Medical School (1999).

NPPES Registry Identity

NPI1932179439
Entity TypeIndividualFemale
Primary Taxonomy207L00000X
Provider Legal NameDR. JESSIE FANCredential: MD
Location Address120 NW 14TH AVE, SUITE 300Portland, OR 97209-2643
Mailing Address2415 Se Ivon StPortland, OR 97202-1287 · (503) 922-0926
Phone(503) 299-9906
Fax(503) 225-9002
Sole ProprietorNo
Medical School CMSRutgers New Jersey Medical SchoolGraduated 1999
Enumeration DateJanuary 25, 2006
Last NPPES UpdateFebruary 15, 2012
✔ NPI 1932179439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
Licenses✔ Licensed in OR · MD27402✔ Licensed in NY · 227596
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
120 NW 14TH AVE, Portland, OR 97209
Open in Google Maps ↗

Other Identifiers 5

Medicaid8482242WA
Medicare PIN137783OR
Medicare UPINH99883
Medicare ID-Type Unspecified9K5941
Medicaid274300OR

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jessie Fan Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4486545365
PECOS Enrollment IDI20070709000339
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.

Medicare Billing Reassignment

Medicare enrollment records show Jessie Fan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kaiser Foundation Health Plan Of The Northwest
0.6 mi
General Practice
1035 NW NORTHRUP ST
Portland, OR 97209
  • Reassigned Medicare billing, Oregon and Washington enrollments
  • Also billed through NPI 1184786527 (Washington)
  • 3,207 clinicians in this Medicare group
NPI 1649722034 (800) 813-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DR. LEE E. DORFMAN DO, MS
Anesthesiology
120 NW 14TH AVE, SUITE 300
PORTLAND, OR 97209
Multnomah County (503) 299-9906
MR. DARIN E BRANDT DO
Anesthesiology
120 NW 14TH AVE, STE 300
PORTLAND, OR 97209
Multnomah County (503) 299-9906
DR. MICHELLE L LOTTO MD
Anesthesiology
120 NW 14TH AVE, STE 300
PORTLAND, OR 97209
Multnomah County (503) 299-9906
REGINALD D. BRUSS MD
Anesthesiology
120 NW 14TH AVE, SUITE 300
PORTLAND, OR 97209
Multnomah County (503) 299-9906
DR. COLLIN S KAEDER MD
Anesthesiology
120 NW 14TH AVE, STE 300
PORTLAND, OR 97209
Multnomah County (503) 299-9906
DR. IAN K. EHRLICH MD
Anesthesiology
120 NW 14TH AVE, SUITE 300
PORTLAND, OR 97209
Multnomah County (503) 299-9906
DR. TRACEY I. BERRY MD
Anesthesiology
120 NW 14TH AVE, SUITE 300
PORTLAND, OR 97209
Multnomah County (503) 299-9906
DR. IAN CARTWRIGHT MD
Anesthesiology
120 NW 14TH AVE, SUITE 300
PORTLAND, OR 97209
Multnomah County (503) 299-9906

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 Jessie Fan's NPI number?

The NPI number for Jessie Fan is 1932179439. It was assigned to this individual provider in the NPPES registry on January 25, 2006.

Where is Jessie Fan located?

Jessie Fan practices at 120 NW 14th Ave Suite 300, Portland, OR 97209. The listed phone number is (503) 299-9906.

What is Jessie Fan's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Jessie Fan enrolled in Medicare?

Yes. Jessie Fan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jessie Fan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessie Fan reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Northwest (Portland, OR). The 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 Jessie Fan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jessie Fan was last updated on February 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.