Individual provider Active NPI

Peter Alexander Leahey, M.D.

  • Infectious Disease Physician
  • Portland, OR
National Provider Identifier
1104143726
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD161118 Issued in OR
Practice address
3550 N Interstate Ave
Interstate Medical Office Building
Portland, OR 97227-1196
Phone
(503) 249-3442
NPI assigned
Apr 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD60344929 WA
Infectious Disease Physician 207RI0200X MD161118 OR Primary

Addresses

Primary practice location

3550 N Interstate Ave
Interstate Medical Office Building
Portland, OR 97227-1196

Mailing address

3550 N Interstate Ave
Portland, OR 97227-1196
Phone (503) 249-5536

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Northwest Permanente PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130806000732 WA Practitioner - Internal Medicine 5698920148 Reassigns benefits to 1 organization
I20160927001364 OR Practitioner - Internal Medicine 5698920148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albany Medical College of Union University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

1230 7TH Ave
Longview, WA 98632-3166
Phone (800) 813-2000

14406 NE 20TH Ave
Vancouver, WA 98686-1448
Phone (800) 813-2000

1700 NE 102ND Ave
Portland, OR 97220-3804
Phone (800) 813-2000

19185 SW 90TH Ave
Tualatin, OR 97062-7558
Phone (800) 813-2000

19500 SE Stark St
Portland, OR 97233-5757
Phone (800) 813-2000

2400 Lancaster Dr NE
Salem, OR 97305-1221
Phone (800) 813-2000

3500 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 813-2000

3550 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 813-2000

3600 N Interstate Ave
Portland, OR 97227-1106
Phone (800) 813-2000

3620 N Interstate Ave
Portland, OR 97227-1106
Phone (800) 813-2000

4855 SW Western Ave
Beaverton, OR 97005-3460
Phone (800) 813-2000

5125 Skyline Rd S
Salem, OR 97306-9427
Phone (800) 813-2000

5940 Ulali Dr NE
Keizer, OR 97303-1500
Phone (800) 813-2000

7101 NE 137TH Ave
Vancouver, WA 98682-4933
Phone (800) 813-2000

9800 SE Sunnyside Rd
Clackamas, OR 97015-9750
Phone (800) 813-2000

9900 SE Sunnyside Rd
Clackamas, OR 97015-9777
Phone (800) 813-2000

Hospital & facility affiliations

  • Kaiser Sunnyside Medical Center Hospital, Clackamas, OR, CCN 380091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60344929WAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 15, 2016 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 15, 2016 Accepting new patients

Locations

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

3550 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

3550 N Interstate Ave
Ofc
Portland, OR 97227
Phone (503) 285-9321

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

2211 E Mill Plain Blvd
Vancouver, WA 98661
Phone (360) 418-6001

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 1

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": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1104143726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 N INTERSTATE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271196",
            "telephone_number": "503-249-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 N INTERSTATE AVE",
            "address_2": "INTERSTATE MEDICAL OFFICE BUILDING",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271196",
            "telephone_number": "503-249-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAHEY",
        "first_name": "PETER",
        "middle_name": "ALEXANDER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-21",
        "last_updated": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WA",
            "license": "MD60344929",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OR",
            "license": "MD161118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Northwest Permanente PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3550 N Interstate Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972271196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.