1. Home
  2. Directory
  3. Oregon
  4. City
  5. Internal Medicine
  6. NPI Profile

PROVIDENCE HEALTH & SERVICES OREGON
NPI 1992138309
Internal Medicine in Oregon City, OR

Active since August 21, 2013
1511 DIVISION ST STE 101, OREGON CITY, OR 97045(503) 722-3705(503) 722-3750 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, May 5, 2025, Apr 24, 2019 (3 updates tracked since 2019).

About Providence Health & Services Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES OREGON (NPI 1992138309), doing business as Providence Medical Group, is a healthcare organization registered as an internal medicine in Oregon City, Oregon and active in the NPI registry since August 2013. The organization lists Donald Wayne Anderson, Asst Secretary For Enrollments, as its authorized official.

NPPES Registry Identity

NPI1992138309
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES OREGON
Location Address1511 DIVISION ST STE 101Oregon City, OR 97045-1589
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180
Phone(503) 722-3705
Fax(503) 722-3750
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAsst Secretary For Enrollments · (425) 358-9786
Enumeration DateAugust 21, 2013
Last NPPES UpdateJuly 4, 20253 updates tracked since enumeration
NPPES CertifiedJuly 4, 2025
✔ NPI 1992138309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPsychiatry & Neurology · Child & Adolescent PsychiatryTaxonomy 2084P0804X
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X
1511 DIVISION ST STE 101, Oregon City, OR 97045
Open in Google Maps ↗

Other Names 2

Doing Business AsProvidence Medical Group
Doing Business AsProvidence Willamette Falls Child Adolescent Outpatient Psychiatry

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

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, 7 practice at this address and 187 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
Zachary Muscato, D.O.
Psychiatry
NPI 1124480264
1511 DIVISION ST STE 101
Oregon City, OR 97045
(971) 345-5060
✔ PECOSSame address
Jin Cai, D.O.
Psychiatry
NPI 1174973358
1511 DIVISION ST STE 101
Oregon City, OR 97045
(971) 345-5060
✔ PECOSSame address
Erica Capretta, LCSW
Clinical Social Worker
NPI 1427432145
1511 DIVISION ST STE 101
Oregon City, OR 97045
(503) 722-3705
✔ PECOSSame address
Tia Nadler, PMHNP
Nurse Practitioner
NPI 1134737521
1511 DIVISION ST STE 101
Oregon City, OR 97045
(503) 722-3705
✔ PECOSSame address
Elizabeth Wong, LCSW
Clinical Social Worker
NPI 1689024432
1511 DIVISION ST STE 101
Oregon City, OR 97045
(503) 722-3705
✔ PECOSSame address
Garnett Wong, L.P.C.
Mental Health Counselor
NPI 1811023310
1511 DIVISION ST STE 101
Oregon City, OR 97045
(503) 722-3705
✔ PECOSSame address
John Domreis, M.D.
General Surgery
NPI 1629168646
1510 DIVISION ST STE 210
Oregon City, OR 97045
(503) 723-6525
✔ PECOS✔ Accepts MedicareSame address
William Davies, M.D.
Cardiovascular Disease (Cardiology)
NPI 1154327625
1510 DIVISION ST STE 200
Oregon City, OR 97045
(503) 962-1000
✔ PECOS✔ Accepts Medicare0.1 mi
Shannon Ehleringer, D.O.
Family Practice
NPI 1568606770
1510 DIVISION ST STE 200
Oregon City, OR 97045
(503) 650-6880
✔ PECOS✔ Accepts Medicare0.1 mi
Melissa Lin, M.D.
General Surgery
NPI 1659735751
1510 DIVISION ST STE 210
Oregon City, OR 97045
(503) 723-6525
✔ PECOS✔ Accepts Medicare0.1 mi
Thomas Huber, MD
Gastroenterology
NPI 1740205830
1510 DIVISION ST STE 210
Oregon City, OR 97045
(503) 723-6525
✔ PECOS✔ Accepts Medicare0.1 mi
Kevin Jamison, MD
Neurology
NPI 1003811373
1510 DIVISION ST STE 180
Oregon City, OR 97045
(503) 742-6900
✔ PECOS✔ Accepts Medicare0.1 mi
Zachary Amos, DO
Internal Medicine
NPI 1831776582
1500 DIVISION ST
Oregon City, OR 97045
(503) 656-1631
✔ PECOS✔ Accepts Medicare0.1 mi
Megan Ayers, FNP
Nurse Practitioner
NPI 1043093206
1500 DIVISION ST STE 220
Oregon City, OR 97045
(503) 513-1900
✔ PECOS✔ Accepts Medicare0.1 mi
Amit Barve, MD
Hospitalist
NPI 1760667059
1500 DIVISION ST
Oregon City, OR 97045
(503) 650-6270
✔ PECOS✔ Accepts Medicare0.1 mi
Kenneth Ensroth, MD
Psychiatry
NPI 1770599185
1500 DIVISION ST CHILD CLINIC
Oregon City, OR 97045
(503) 722-3700
✔ PECOS✔ Accepts Medicare0.1 mi
Poorni Manohar, MD
Hematology
NPI 1912343807
1500 DIVISION ST STE 220
Oregon City, OR 97045
(503) 513-1900
✔ PECOS✔ Accepts Medicare0.1 mi
Shane Rogosin, MD
Medical Oncology
NPI 1447451794
1500 DIVISION ST STE 220
Oregon City, OR 97045
(503) 513-1900
✔ PECOS✔ Accepts Medicare0.1 mi
Jodi Moon, R.D., C.D.E
Registered Dietitian or Nutrition Professional
NPI 1679891501
519 15TH ST
Oregon City, OR 97045
(503) 650-6822
✔ Accepts Medicare0.6 mi
Michael Kozlowski, PH.D.
Clinical Psychologist
NPI 1770864688
619 MADISON ST STE 108
Oregon City, OR 97045
(503) 303-4257
✔ PECOS✔ Accepts Medicare0.7 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 1992138309. It was assigned to this organization in the NPPES registry on August 21, 2013. The provider is doing business as Providence Medical Group and Providence Willamette Falls Child Adolescent Outpatient Psychiatry.

Where is Providence Health & Services Oregon located?

Providence Health & Services Oregon is located at 1511 Division St Ste 101, Oregon City, OR 97045. The listed phone number is (503) 722-3705.

What is Providence Health & Services Oregon's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

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, 7 practice at this address and 187 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 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.