NPIMap

Individual provider Active NPI

Michael Lee McDonald, M.D.

  • Sleep Medicine (Otolaryngology) Physician
  • Portland, OR
National Provider Identifier
1053589465
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Otolaryngology) PhysicianTaxonomy code 207YS0012X
License
MD00041925 Issued in WA
Practice address
10101 SE Main St
# 2004
Portland, OR 97216-2455
Phone
(503) 257-3204
Fax
(503) 255-7208
NPI assigned
Feb 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Otolaryngology) Physician 207YS0012X MD00041925 WA Primary

Addresses

Primary practice location

10101 SE Main St
# 2004
Portland, OR 97216-2455

Mailing address

10101 SE Main St
# 2004
Portland, OR 97216-2455
Phone (503) 257-3204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Primary Care Group, PC Past Accepting new patients
Mt. Hood Ear, Nose & Throat PC PastSince Mar 1, 2013 Accepting new patients

Organizations & group practices 2

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": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1053589465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 SE MAIN ST",
            "address_2": "# 2004",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162455",
            "telephone_number": "503-257-3204",
            "fax_number": "503-255-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 SE MAIN ST",
            "address_2": "# 2004",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162455",
            "telephone_number": "503-257-3204",
            "fax_number": "503-255-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "WA",
            "license": "MD00041925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.