NPIMap

Organization Active NPI

Gerald B Rich, MD, PC

  • Sleep Medicine (Internal Medicine) Physician
  • Portland, OR
National Provider Identifier
1083855175
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
Legal business name
GERALD B RICH, MD, PC
Practice address
11790 SW Barnes Rd
Suite 330
Portland, OR 97225-5934
Phone
(503) 228-4414
Fax
(503) 228-7293
NPI assigned
Mar 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Authorized official

Name
Dr. Radhika Breaden, M.D.NPI 1154462257
Title
President
Phone
(503) 228-4414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X Primary

Addresses

Primary practice location

11790 SW Barnes Rd
Suite 330
Portland, OR 97225-5934

Mailing address

11790 SW Barnes Rd
Suite 330
Portland, OR 97225-5934
Phone (503) 228-4414

Other practice location 1

2120 Exchange St Ste 302
Astoria, OR 97103-3364
Phone (503) 325-5175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090427000008 OR Part B Supplier - Clinic/Group Practice 0143378471 Receives reassigned benefits from 10 practitioners
Practice locations: Astoria, OR; Portland, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594944000000",
    "number": "1083855175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11790 SW BARNES RD",
            "address_2": "SUITE 330",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255934",
            "telephone_number": "503-228-4414",
            "fax_number": "503-228-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11790 SW BARNES RD",
            "address_2": "SUITE 330",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255934",
            "telephone_number": "503-228-4414",
            "fax_number": "503-228-7293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 Exchange St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "OR",
            "postal_code": "971033364",
            "country_code": "US",
            "telephone_number": "503-325-5175",
            "fax_number": "503-228-4414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GERALD B RICH, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A",
        "authorized_official_last_name": "BREADEN",
        "authorized_official_first_name": "RADHIKA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-228-4414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "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 Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.