Individual provider Active NPI

Peter Jessel, M.D.

  • Cardiovascular Disease Physician
  • Portland, OR
National Provider Identifier
1023136199
Registry record updated Mar 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD151025 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Uhn-62
Portland, OR 97239-3011
Phone
(503) 494-8750
Fax
(503) 494-8550
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD151025 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Uhn-62
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Uhn-62
Portland, OR 97239-3011
Phone (503) 494-8750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100916000653 OR Practitioner - Cardiovascular Disease (Cardiology) 9638294499 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD151025ORMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jul 1, 2013 Accepting new patients
University Professional Services CurrentSince Jul 1, 2013 Accepting new patients
University Professional Services Current Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3181 SW Sam Jackson Park Rd
#62
Portland, OR 97239
Phone (503) 494-1775

Interoperability endpoints

  • Direct secure messaging: pjesselmd11773@direct.ohsu.edu

Organizations & group practices 3

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1023136199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "UHN-62",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8750",
            "fax_number": "503-494-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "UHN-62",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8750",
            "fax_number": "503-494-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEL",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD151025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.