Individual provider Active NPI

Jacqueline Ana Levene, DO

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1043673866
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO196603 Issued in OR
Practice address
4400 NE Halsey St Ste 102
Portland, OR 97213-1545
Phone
(503) 962-1000
Fax
(503) 962-1005
NPI assigned
Mar 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology Physician 207UN0901X DO196603 OR
Cardiovascular Disease Physician 207RC0000X OT021403 PA
Internal Medicine Physician 207R00000X DO196603 OR Primary

Addresses

Primary practice location

4400 NE Halsey St Ste 102
Portland, OR 97213-1545

Mailing address

4400 NE Halsey St Ste 102
Portland, OR 97213-1545
Phone (503) 962-1000

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
I20250909002990 OR Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 9436400157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services OregonGroup PAC ID 7315856010, shared by 5 NPIs, 80 clinicians
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

1108 June St
Hood River, OR 97031-1513
Phone (541) 387-6125

1510 Division St
Suite 200
Oregon City, OR 97045-1599
Phone (503) 650-6880

Hospital & facility affiliations

  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT021403PAMDCardiovascular Disease Physician
DO196603ORMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Oct 6, 2025 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 6, 2025 Accepting new patients
Providence Health & Services - Oregon Internal Medicine Past Accepting new patients

Locations

1510 Division St
Ste 200
Oregon City, OR 97045
Phone (503) 650-6880

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

4400 NE Halsey St
Bldg 1
Portland, OR 97213
Phone (503) 215-6262

4400 NE Halsey St
Ste 102
Portland, OR 97213
Phone (503) 216-0990

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

Interoperability endpoints

  • Direct secure messaging: jlevene786492@oc.providencedirect.org

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 6

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": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1043673866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 NE HALSEY ST STE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131545",
            "telephone_number": "503-962-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 NE HALSEY ST STE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131545",
            "telephone_number": "503-962-1000",
            "fax_number": "503-962-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENE",
        "first_name": "JACQUELINE",
        "middle_name": "ANA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "OR",
            "license": "DO196603",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OT021403",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO196603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.