Providence Health & Services Oregon
NPI 1164623401 · Internal Medicine Physician · Portland, OR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Providence Health & Services Oregon is a Internal Medicine Physician organization in Portland, OR (NPI 1164623401).
Provider details
- NPI number
- 1164623401
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secretary of Enrollments(425) 358-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Social Worker104100000X
Behavioral Health & Social Service Providers
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Providence Medical Group
- Doing business as
- Providence Medical Group
Registry dates
- Enumerated
- 2007-05-31
- Last updated
- 2025-06-20
- Certified
- 2025-06-20
Frequently asked questions
- What is Providence Health & Services Oregon's NPI number?
- Providence Health & Services Oregon's National Provider Identifier (NPI) is 1164623401, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Providence Health & Services Oregon?
- Providence Health & Services Oregon is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Providence Health & Services Oregon located?
- Providence Health & Services Oregon's practice location on file with NPPES is 4400 Ne Halsey St, Portland, OR 97213-1545.
- What is Providence Health & Services Oregon's phone number?
- The practice phone number listed in the NPPES registry for Providence Health & Services Oregon is (503) 893-6524.
- Does Providence Health & Services Oregon accept Medicare?
- Providence Health & Services Oregon is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Providence Health & Services Oregon?
- The authorized official listed on Providence Health & Services Oregon's NPPES record is Donald Anderson, Assistant Secretary of Enrollments. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Providence Health & Services Oregon's NPI active?
- Yes — Providence Health & Services Oregon's NPI (1164623401) is active in the NPPES registry as of the last update on 2025-06-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.