Individual provider Active NPI

Ian Holmes, MD

  • Gastroenterology Physician
  • Portland, OR
National Provider Identifier
1073933099
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD204232 Issued in OR
Practice address
1111 NE 99TH Ave Ste 301
Portland, OR 97220-9442
Phone
(503) 963-2707
Fax
(503) 963-2802
NPI assigned
Apr 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD204232 OR Primary

Addresses

Primary practice location

1111 NE 99TH Ave Ste 301
Portland, OR 97220-9442

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other practice location 1

9300 SE 91st Ave Ste 300
Happy Valley, OR 97086-3762
Phone (503) 963-2707

Other identifiers 2

IdentifierTypeStateIssuer
500791915MedicaidOR
2176196MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_gastro_east_front_desk_pool12223282@oc.providencedirect.org The Oregon Clinic PC

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
I20210510000110 OR Practitioner - Gastroenterology 7214367283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

1111 NE 99TH Ave
Portland, OR 97220-9442

4805 NE Glisan
Portland, OR 97213-2933

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

9300 SE 91St Ave
Suite 300
Happy Valley, OR 97086-3762
Phone (503) 963-2707

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy52
Upper gastrointestinal (GI) endoscopy for acid reflux137

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: iholmes1705122@oc.providencedirect.org

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.

Hospital & facility affiliations 5

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1073933099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 NE 99TH AVE STE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209442",
            "telephone_number": "503-963-2707",
            "fax_number": "503-963-2802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 SE 91st Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Happy Valley",
            "state": "OR",
            "postal_code": "970863762",
            "country_code": "US",
            "telephone_number": "503-963-2707",
            "fax_number": "503-963-2802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "IAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "MD204232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500791915",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2176196",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_gastro_east_front_desk_pool12223282@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "1111 NE 99th Ave Ste 301",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972209442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.