Individual provider Active NPI

David William Cook, M.D.

  • Surgery Physician
  • Beaverton, OR
National Provider Identifier
1093804353
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD14334 Issued in OR
Practice address
11000 SW Stratus St Ste 215
Beaverton, OR 97008-7104
Phone
(503) 297-1351
Fax
(503) 297-2851
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD14334 OR Primary

Addresses

Primary practice location

11000 SW Stratus St Ste 215
Beaverton, OR 97008-7104

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
8490310MedicaidWA
009089MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_general_surgery_west_front_desk_pool12223197@oc.providendedirect.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
I20070910000021 OR Practitioner - General Surgery 4789777665 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14334ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic PC CurrentSince Sep 1, 2007 Accepting new patients
The Oregon Clinic, PC CurrentSince Sep 1, 2007 Accepting new patients

Locations

9155 SW Barnes Rd
Ste 735
Portland, OR 97225
Phone (503) 297-4123

847 NE 19th Ave
Ste 300
Portland, OR 97232

9155 SW Barnes Rd
Ste 940
Portland, OR 97225
Phone (503) 297-1351

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

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

Interoperability endpoints

  • Direct secure messaging: cc_otoc_general_surgery_west_front_desk_pool12223197@oc.providendedirect.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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1093804353",
    "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": "11000 SW STRATUS ST STE 215",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087104",
            "telephone_number": "503-297-1351",
            "fax_number": "503-297-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "DAVID",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD14334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8490310",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009089",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_general_surgery_west_front_desk_pool12223197@oc.providendedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "11000 SW Stratus St Ste 215",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970087104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.