Individual provider Active NPI

John Gilbert Buckmaster, MD

  • Obstetrics & Gynecology Physician
  • Portland, OR
National Provider Identifier
1013922525
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD12764 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-4200
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD12764 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

2070 Ridge Pointe Dr
Lake Oswego, OR 97034-7572

Other identifiers 1

IdentifierTypeStateIssuer
289702MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070730000726 WA Practitioner - Obstetrics/Gynecology 4183725484 Reassigns benefits to 1 organization
I20090429000421 OR Practitioner - Obstetrics/Gynecology 4183725484 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Oregon Health Sciences University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

2101 NE 139TH St
Suite 260
Vancouver, WA 98686-2311
Phone (360) 487-2870

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487

300 N Graham
100 Maternal Fetal Med
Portland, OR 97227-1667
Phone (503) 413-1122

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
96.26
Promoting interoperability
100
Improvement activities
40
Cost
79.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12764ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince May 1, 2009 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince May 1, 2009 Accepting new patients
Good Shepherd Health Care System CurrentSince Aug 1, 2013 Accepting new patients
Legacy Salmon Creek Hospital Obstetrics & Gynecology CurrentSince May 1, 2009 Accepting new patients
Good Shepherd Health Care System CurrentSince Aug 1, 2013 Accepting new patients

Locations

600 NW 11th St
Ste E37
Hermiston, OR 97838
Phone (541) 567-5305

620 NW 11th St
Ste M106
Hermiston, OR 97838
Phone (541) 667-3801

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

300 N Graham St
Ste 100
Portland, OR 97227
Phone (503) 413-1122

2222 NW Lovejoy St
Ste 601
Portland, OR 97210
Phone (503) 413-5514

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

2101 NE 139th St
Ste 260
Vancouver, WA 98686
Phone (360) 487-2870

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: jbuckmaster1897@direct.lhs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013922525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 RIDGE POINTE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970347572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKMASTER",
        "first_name": "JOHN",
        "middle_name": "GILBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD12764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "289702",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.