Active NPI
Shaun Disney
- Anesthesiology Physician
- Portland, OR
National Provider Identifier
1083147029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD205176
- Practice address
- 707 SW Washington St Ste 700
Portland, OR 97205-3523 - Phone
- (503) 299-9906
- Fax
- (503) 225-9002
- NPI assigned
- Apr 6, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | MD205176 | OR | Primary |
Addresses
Primary practice location
707 SW Washington St Ste 700
Portland, OR 97205-3523
Mailing address
PO Box 35147
#1801
Seattle, WA 98124
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of California, Irvine, California College of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 299-9906
Hospital & facility affiliations
- Legacy Good Samaritan Medical Center
- Legacy Emanuel Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oregon Anesthesiology Group PC | Anesthesiology | Current | Accepting new patients |
| Oag Trauma Services LLC | Anesthesiology | Past | Accepting new patients |
Locations
1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538
707 SW Washington St
Ste 700
Portland, OR 97205
9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234
2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985
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.
-
- Anesthesiology Physician
- Portland, OR
- NPI 1548669948
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003367491
-
- Clinical Medical Laboratory
- Portland, OR
- NPI 1295756898
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
- Clinic/Center
- Portland, OR
- NPI 1679597108
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1780608216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1083147029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 35147",
"address_2": "#1801",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 SW WASHINGTON ST STE 700",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972053523",
"telephone_number": "503-299-9906",
"fax_number": "503-225-9002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISNEY",
"first_name": "SHAUN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-06",
"last_updated": "2021-09-01",
"certification_date": "2021-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OR",
"license": "MD205176",
"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 Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.