Individual provider Active NPI

Andrew Marc Friede, MD, MPH

  • Addiction Medicine (Preventive Medicine) Physician
  • Portland, OR
National Provider Identifier
1063979060
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
License
35882 Issued in AL
Practice address
111 SW 5TH Ave
Portland, OR 97204-3604
Phone
(260) 577-2266
NPI assigned
Feb 26, 2019
Last updated
May 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 35882 AL
Addiction Medicine (Preventive Medicine) Physician 2083A0300X 35882 AL Primary
Obesity Medicine (Preventive Medicine) Physician 2083B0002X 35882 AL

Addresses

Primary practice location

111 SW 5TH Ave
Portland, OR 97204-3604

Mailing address

800 NW Powhatan Ter
Portland, OR 97210-2733
Phone (260) 577-2266

Other identifiers 1

IdentifierTypeStateIssuer
12345OtherPLACEHOLDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190805000378 AL Practitioner - Preventive Medicine 3072840727 Reassigns benefits to 3 organizations
I20230815002323 OR Practitioner - Addiction MedicinePractitioner - Preventive Medicine 3072840727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Addiction MedicineAlso: Preventive Medicine
Education
Johns Hopkins University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

111 SW 5TH Ave
Suite 3150
Portland, OR 97204-3656
Phone (260) 557-2266

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35882ALMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aletheia House, Inc. CurrentSince Jan 1, 2022 Accepting new patients
Signify Health, LLC CurrentSince Jun 10, 2021 Accepting new patients
Kolbe Clinic LLC CurrentSince Nov 11, 2020 Accepting new patients
Bluestone Clinic LLC Public Health & General Preventive Medicine CurrentSince Jun 28, 2023 Accepting new patients
SVPS Psychiatric Services LLC Past Accepting new patients

Locations

2201 Arlington Ave
Bessemer, AL 35020
Phone (205) 277-6878

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

109 Foothills Pkwy
Ste 113
Chelsea, AL 35043
Phone (205) 451-9742

1830 Montclair Rd
Ste A
Irondale, AL 35210
Phone (205) 775-0300

111 SW 5th Ave
Ste 3150
Portland, OR 97204
Phone (253) 300-8453

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15655/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1063979060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 NW POWHATAN TER",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102733",
            "telephone_number": "260-577-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SW 5TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972043604",
            "telephone_number": "260-577-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDE",
        "first_name": "ANDREW",
        "middle_name": "MARC",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-26",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "AL",
            "license": "35882",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "AL",
            "license": "35882",
            "primary": true
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "AL",
            "license": "35882",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PLACEHOLDER",
            "identifier": "12345",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.