NPIMap

Individual provider Active NPI

Stacy K Lewis, MD

  • Medical Oncology Physician
  • Portland, OR
National Provider Identifier
1124021753
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
MD21052 Issued in OR
Practice address
9135 SW Barnes Rd Ste 261
Portland, OR 97225-6784
Phone
(503) 216-6300
Fax
(503) 216-6324
NPI assigned
May 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MD21052 OR
Medical Oncology Physician 207RX0202X MD21052 OR Primary

Addresses

Primary practice location

9135 SW Barnes Rd Ste 261
Portland, OR 97225-6784

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other identifiers 2

IdentifierTypeStateIssuer
8244568MedicaidWA
151176MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slewis109710@oc.providencedirect.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080214000107 OR Practitioner - Medical OncologyPractitioner - Hematology 6901848597 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology
Education
Washington University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213-2933

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

9135 SW Barnes Rd
Suite 261
Portland, OR 97225-6784
Phone (503) 216-6300

9205 SW Barnes Rd
Portland, OR 97225-6603

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21052ORMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Sep 17, 2012 Accepting new patients
Providence Health & Services - Oregon CurrentSince Mar 30, 2020 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 30, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Dec 19, 2007 Accepting new patients
Providence Health & Services - Oregon CurrentSince Mar 30, 2020 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 30, 2018 Accepting new patients
Providence Health & Services - Oregon CurrentSince Mar 30, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Mar 30, 2020 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 17, 2012 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Dec 19, 2007 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Pacific Oncology PC Hematology & Oncology PastSince Jun 1, 2000 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

9135 SW Barnes Rd
Ste 261
Portland, OR 97225
Phone (503) 215-8650

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1124021753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 SW BARNES RD STE 261",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256784",
            "telephone_number": "503-216-6300",
            "fax_number": "503-216-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "STACY",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OR",
            "license": "MD21052",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "OR",
            "license": "MD21052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8244568",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151176",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slewis109710@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9135 SW Barnes Rd",
            "address_2": "STE 261",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.