NPIMap

Individual provider Active NPI

Elizabeth S Severson, DO

  • Internal Medicine Physician
  • Newberg, OR
National Provider Identifier
1073048450
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO211616 Issued in OR
Practice address
1000 N Providence Dr Ste 120
Newberg, OR 97132-7582
Phone
(503) 537-5900
NPI assigned
Apr 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO211616 OR Primary

Addresses

Primary practice location

1000 N Providence Dr Ste 120
Newberg, OR 97132-7582

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other practice location 1

9205 SW Barnes Rd Ste Mt2800
Portland, OR 97225-6603
Phone (503) 216-2621

Other practice location 2

200 Mullins Dr
Lebanon, OR 97355-3983
Phone (541) 259-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220726001565 OR Practitioner - Internal Medicine 9537494034 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 N Providence Dr
Suite 120
Newberg, OR 97132-7582
Phone (503) 537-5900

1001 N Providence Dr
Newberg, OR 97132-7485
Phone (503) 537-1555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO211616ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2022 Accepting new patients
Western University of Health Sciences Past Accepting new patients
Providence Health & Services - Oregon Internal Medicine Past Accepting new patients

Locations

1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538

1000 N Providence Dr
Ste 120
Newberg, OR 97132
Phone (503) 537-5700

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

9205 SW Barnes Rd
Ste MT2800
Portland, OR 97225
Phone (503) 216-2621

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

Interoperability endpoints

  • Direct secure messaging: eseverson971799@oc.providencedirect.org

Organizations & group practices 7

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 8

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1073048450",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N PROVIDENCE DR STE 120",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327582",
            "telephone_number": "503-537-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9205 SW Barnes Rd Ste Mt2800",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256603",
            "country_code": "US",
            "telephone_number": "503-216-2621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Mullins Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973553983",
            "country_code": "US",
            "telephone_number": "541-259-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEVERSON",
        "first_name": "ELIZABETH",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO211616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

Verify at the official NPI Registry.