Individual provider Active NPI

Ryan J De Lee, MD

  • Gastroenterology Physician
  • Springfield, OR
National Provider Identifier
1104920693
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD161864 Issued in OR
Practice address
3355 Riverbend Dr Ste 500
Springfield, OR 97477-8800
Phone
(541) 868-9500
Fax
(541) 685-5920
NPI assigned
Sep 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD161864 OR Primary

Addresses

Primary practice location

3355 Riverbend Dr Ste 500
Springfield, OR 97477-8800

Mailing address

3355 Riverbend Dr Ste 500
Springfield, OR 97477-8800
Phone (541) 868-9500

Other practice location 1

1007 Harlow Rd
Suite 350
Springfield, OR 97477-7124
Phone (541) 284-1600

Other identifiers 1

IdentifierTypeStateIssuer
500666820MedicaidOR

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
I20140115000234 OR Practitioner - Gastroenterology 7416087671 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Loyola University of Chicago, Stritch School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eugene Gastroenterology Consultants PCGroup PAC ID 9830185875, 16 clinicians

Practice addresses (Care Compare)

3355 Riverbend Dr
Suite 500
Springfield, OR 97477-8800
Phone (541) 868-9500

Hospital & facility affiliations

  • Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102
  • Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090
  • Mercy Medical Center Hospital, Roseburg, OR, CCN 380027
  • Peacehealth Cottage Grove Community Medical Center Hospital, Cottage Grove, OR, CCN 381301
  • Peace Harbor Medical Center Hospital, Florence, OR, CCN 381316

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy75
Upper gastrointestinal (GI) endoscopy for acid reflux159

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Corvallis Gastroenterology PC CurrentSince Jan 1, 2019 Accepting new patients
McKenzie Physician Services LLC CurrentSince Nov 1, 2018 Accepting new patients
Eugene Gastroenterology Consultants PC Gastroenterology CurrentSince Mar 2, 2020 Accepting new patients
Radiology Associates PC PastSince May 16, 2021 Accepting new patients
Peacehealth Past Accepting new patients

Locations

1046 6th Ave SW
Albany, OR 97321
Phone (541) 812-4000

1750 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-0333

3521 NW Samaritan Dr
Ste 101
Corvallis, OR 97330
Phone (541) 768-6119

3355 Riverbend Dr
#500
Springfield, OR 97477
Phone (541) 868-9506

960 N 16th St
Ste 304
Springfield, OR 97477
Phone (541) 744-6172

3355 Riverbend Dr
Ste 500
Springfield, OR 97477
Phone (541) 868-9506

1007 Harlow Rd
Ste 350
Springfield, OR 97477
Phone (541) 284-1600

Interoperability endpoints

  • Direct secure messaging: rdelee@yourcarecommunity.org

Organizations & group practices 5

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 6

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1104920693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 RIVERBEND DR STE 500",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-868-9500",
            "fax_number": "541-685-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 RIVERBEND DR STE 500",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-868-9500",
            "fax_number": "541-685-5920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 Harlow Rd",
            "address_2": "Suite 350",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974777124",
            "country_code": "US",
            "telephone_number": "541-284-1600",
            "fax_number": "541-684-3074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LEE",
        "first_name": "RYAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "MD161864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500666820",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.