Individual provider Active NPI

Deane C De Fontes, MD

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1114050754
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MC24712 Issued in OR
Practice address
426 SW Stark St
8TH Floor
Portland, OR 97204-2347
Phone
(503) 988-3674
Fax
(503) 988-3142
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MC24712 OR Primary

Addresses

Primary practice location

426 SW Stark St
8TH Floor
Portland, OR 97204-2347

Mailing address

1027 E Burnside St
Portland, OR 97214-1328
Phone (503) 239-8400

Other practice location 1

720 SE Washington St
Hillsboro, OR 97123-4230
Phone (503) 648-0753

Other identifiers 1

IdentifierTypeStateIssuer
022959MedicaidOR

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
I20040519001157 OR Practitioner - Family Practice 1951392992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Un of California, Irvine, College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multnomah CountyGroup PAC ID 6608771787, 111 clinicians

Practice addresses (Care Compare)

12710 SE Division
Mid County Health Center
Portland, OR 97236-3134
Phone (503) 988-3601

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MC24712ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Feb 21, 2010 Accepting new patients
Coda, Inc. CurrentSince Jun 15, 2025 Accepting new patients
Multnomah County CurrentSince Feb 21, 2010 Accepting new patients
Coda, Inc. CurrentSince Jun 15, 2025 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

1027 E Burnside St
Portland, OR 97214

12710 SE Division St
Portland, OR 97236
Phone (503) 988-3410

Interoperability endpoints

  • Direct secure messaging: ddefontes7491@direct.ochin.org

Organizations & group practices 4

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1114050754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8400",
            "fax_number": "503-239-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 SW STARK ST",
            "address_2": "8TH FLOOR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042347",
            "telephone_number": "503-988-3674",
            "fax_number": "503-988-3142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 SE Washington St",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234230",
            "country_code": "US",
            "telephone_number": "503-648-0753",
            "fax_number": "503-648-0755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE FONTES",
        "first_name": "DEANE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MC24712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022959",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.