NPIMap

Individual provider Active NPI

Jill C Edminster, D.O.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1114193836
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO153185 Issued in OR
Practice address
2282 NW Northrup St
Legacy Medical Group
Portland, OR 97210-2919
Phone
(503) 276-8885
NPI assigned
May 2, 2008
Last updated
Feb 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO153185 OR Primary

Addresses

Primary practice location

2282 NW Northrup St
Legacy Medical Group
Portland, OR 97210-2919

Mailing address

2282 NW Northrup St
Legacy Medical Group
Portland, OR 97210-2919
Phone (503) 276-8885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111026000984 OR Practitioner - Internal Medicine 9537332150 Reassigns benefits to 3 organizations
I20240717000733 WA Practitioner - Internal Medicine 9537332150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711

1015 Nw22Nd Ave
Suite 34
Portland, OR 97210-3025
Phone (503) 413-6376

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-1122

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
96.26
Promoting interoperability
100
Improvement activities
40
Cost
79.84

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Jun 30, 2024 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Aug 19, 2011 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Aug 19, 2011 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Aug 19, 2011 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Aug 19, 2011 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Jun 30, 2024 Accepting new patients
Legacy Clinics LLC CurrentSince Aug 19, 2011 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Aug 19, 2011 Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2800 N Vancouver Ave
Ste 230
Portland, OR 97227
Phone (503) 413-2901

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 10

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.

Hospital & facility affiliations 8

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": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1114193836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2282 NW NORTHRUP ST",
            "address_2": "LEGACY MEDICAL GROUP",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102919",
            "telephone_number": "503-276-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2282 NW NORTHRUP ST",
            "address_2": "LEGACY MEDICAL GROUP",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102919",
            "telephone_number": "503-276-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMINSTER",
        "first_name": "JILL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-02",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO153185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.