Individual provider Active NPI

Rachel Kristen Laursen, MD

  • Vascular Neurology Physician
  • Portland, OR
National Provider Identifier
1033615505
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
MD211633 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone
(503) 494-7225
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD211633 OR
Vascular Neurology Physician 2084V0102X MD211633 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone (503) 494-8211

Other practice location 1

2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 706-6892

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
I20221122003644 OR Practitioner - Neurology 6103177548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Oregon Health Sciences University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD211633ORMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jul 1, 2023 Accepting new patients
St. Charles Health System, Inc. Current Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Jul 1, 2023 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

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

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

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

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

Interoperability endpoints

  • Direct secure messaging: rlaursen87505@direct.ohsu.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1033615505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-8211"
        },
        {
            "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": "972393098",
            "telephone_number": "503-494-7225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 NE Neff Rd",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016015",
            "country_code": "US",
            "telephone_number": "541-706-6892",
            "fax_number": "541-706-6813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAURSEN",
        "first_name": "RACHEL",
        "middle_name": "KRISTEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD211633",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "OR",
            "license": "MD211633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.