Individual provider Active NPI

Lisa Kendell Sanders, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Portland, OR
National Provider Identifier
1093128571
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD186799 Issued in OR
Practice address
13007 NE Glisan St
Portland, OR 97230-2545
Phone
(503) 215-7850
NPI assigned
Jun 3, 2014
Last updated
Oct 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD186799 OR Primary
Internal Medicine Physician 207R00000X MD186799 OR

Addresses

Primary practice location

13007 NE Glisan St
Portland, OR 97230-2545

Mailing address

13007 NE Glisan St
Portland, OR 97230-2545
Phone (503) 215-7850

Other practice location 1

2701 NW Vaughn St Ste 160
Portland, OR 97210-5344
Phone (503) 499-5608

Other practice location 2

5050 NE Hoyt St Ste 540
Portland, OR 97213-2985
Phone (503) 215-6600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lsanders437794@oc.providencedirect.org

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
I20181105003497 OR Practitioner - Internal MedicinePractitioner - Geriatric Medicine 9537384623 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Internal Medicine Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Aug 27, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 1, 2019 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Jun 1, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 1, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 1, 2019 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

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

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

5050 NE Hoyt St
Ste 540
Portland, OR 97213
Phone (503) 215-6600

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

7101 NE 137th Ave
Ofc
Vancouver, WA 98682
Phone (360) 944-4802

Interoperability endpoints

  • Direct secure messaging: lsanders437794@oc.providencedirect.org

Organizations & group practices 8

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": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1093128571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13007 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302545",
            "telephone_number": "503-215-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13007 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302545",
            "telephone_number": "503-215-7850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 NW Vaughn St Ste 160",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972105344",
            "country_code": "US",
            "telephone_number": "503-499-5608",
            "fax_number": "503-499-5455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5050 NE Hoyt St Ste 540",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972132985",
            "country_code": "US",
            "telephone_number": "503-215-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "LISA",
        "middle_name": "KENDELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OR",
            "license": "MD186799",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD186799",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsanders437794@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 540",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.