Active NPI
Bridgetown Medical Group P.C.
- Surgery Physician
- Portland, OR
National Provider Identifier
1124088679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- BRIDGETOWN MEDICAL GROUP P.C.
- Practice address
- 10000 SE Main St
Suite 311
Portland, OR 97216 - Phone
- (503) 257-0748
- Fax
- (503) 255-0526
- NPI assigned
- Mar 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lindsay Shaw
- Title
- Office Manager
- Phone
- (503) 416-6510
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | |||
| Surgery Physician | 208600000X | Primary | ||
| Vascular Surgery Physician | 2086S0129X | |||
| Colon & Rectal Surgery Physician | 208C00000X | |||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X |
Addresses
Primary practice location
10000 SE Main St
Suite 311
Portland, OR 97216
Mailing address
10000 SE Main St Ste 212
Portland, OR 97216-2442
Phone (503) 416-6510
Other names 2
- Bridgetown Surgical Clinic
- Healthcare Specialists NW P.C.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Obstetrics & Gynecology Physician
- Portland, OR
- NPI 1396177937
O20040226001071
-
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- San Francisco, CA
- NPI 1093142085
O20040226001071
National Provider Directory
National Provider DirectoryLocations
10000 SE Main St
Ste 311
Portland, OR 97216
Phone (503) 257-0748
10000 SE Main St
Ste 212
Portland, OR 97216
Phone (503) 251-6362
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Portland, OR
- NPI 1528029345
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529107200000",
"number": "1124088679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10000 SE MAIN ST STE 212",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972162442",
"telephone_number": "503-416-6510",
"fax_number": "503-416-6529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10000 SE MAIN ST",
"address_2": "SUITE 311",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97216",
"telephone_number": "503-257-0748",
"fax_number": "503-255-0526"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRIDGETOWN MEDICAL GROUP P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-27",
"last_updated": "2018-06-16",
"status": "A",
"authorized_official_last_name": "SHAW",
"authorized_official_first_name": "LINDSAY",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "503-416-6510"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
},
{
"code": "2086S0129X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208C00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Colon & Rectal Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Bridgetown Surgical Clinic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Bridgetown Surgical Clinic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Healthcare Specialists NW P.C.",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Portland, OR
- Bridget Fragale LMT
- Bridgeton Chiropractic, LLC
- Bridgetown Acupuncture and Herbal Clinic, LLC
- Bridgetown Chiropractic and Wellness PC
- Bridgetown Hearing Clinic
- Bridgetown Medical Group P.C.
- Bridgetown Optometric Associates LLC
- Bridgetown Physical Therapy and Training Studio, PC
- Bridgetown Recovery
- Bridgeview
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.