Individual provider Active NPI

Jeremy S. Swindle, MD

  • Family Medicine Physician
  • Newberg, OR
National Provider Identifier
1053381889
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD26686 Issued in OR
Practice address
1000 N Providence Dr Ste 210
Newberg, OR 97132-7582
Phone
(503) 537-5900
Fax
(503) 537-5900
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD26686 OR Primary
Emergency Medicine Physician 207P00000X 2004022191 MO

Addresses

Primary practice location

1000 N Providence Dr Ste 210
Newberg, OR 97132-7582

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other identifiers 1

IdentifierTypeStateIssuer
028333MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jswindle117956@oc.providencedirect.org

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
I20070123000040 OR Practitioner - Family Practice 8921027285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1003 N Providence Dr
Suite 210
Newberg, OR 97132-7523
Phone (503) 537-5620

1003 N Providence Dr
Suite 325
Newberg, OR 97132-7521
Phone (503) 216-1661

Hospital & facility affiliations

  • Providence Home Health Home health agency, Portland, OR, CCN 387048
  • Providence Hospice Hospice, Portland, OR, CCN 381500
  • Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Willamette Valley Medical Center Hospital, McMinnville, OR, CCN 380071
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004022191MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 28, 2006 Accepting new patients
Providence Health & Services - Oregon Family Medicine Past Accepting new patients

Locations

1003 N Providence Dr
Ste 210
Newberg, OR 97132
Phone (503) 537-5620

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

1000 N Providence Dr
Ste 210
Newberg, OR 97132

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

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.

Hospital & facility affiliations 7

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1053381889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N PROVIDENCE DR STE 210",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327582",
            "telephone_number": "503-537-5900",
            "fax_number": "503-537-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWINDLE",
        "first_name": "JEREMY",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD26686",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2004022191",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028333",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jswindle117956@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1000 N Providence Dr Ste 210",
            "city": "Newberg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971327582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

Verify at the official NPI Registry.