Peter Jack Taylor, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO154273 Issued in OR

Practice address

10202 SE 32ND Ave Ste 701
Milwaukie, OR 97222-3625

Phone

(503) 513-1410

NPI assigned

Nov 2, 2007

Last updated

Oct 6, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 5

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

Specialty

Psychiatry

Education

Mid West Medical College, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
• Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Providence Health & Services Oregon

  dba Providence Medical Group

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Medicare reassignment NPD
• Providence Health & Services Oregon

  dba Providence Milwaukie Hospital

  • General Acute Care Hospital
  • Milwaukie, OR
  • NPI 1366536963
  Medicare reassignment NPD
• Providence Health & Services Oregon

  dba Providence Portland Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Portland, OR
  • NPI 1396818993
  NPD
• Providence Health & Services Oregon

  dba Providence Milwaukie Hospital

  • Clinical Pathology Physician
  • Milwaukie, OR
  • NPI 1578014239

  Family Medicine

  NPD
• Providence Health & Services Oregon

  • Psychiatric Hospital Unit
  • Milwaukie, OR
  • NPI 1659751360
  NPD
• Providence Health & Services Oregon

  dba Providence Medical Group

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Arizona Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1093254419
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Newberg Medical Center

  • General Acute Care Hospital
  • Newberg, OR
  • NPI 1952482275
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1124207436",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10202 SE 32ND AVE STE 701",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972223625",
            "telephone_number": "503-513-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "PETER",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-02",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "005971",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "DO154273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500645932",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptaylor791191@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "10202 SE 32nd Ave Ste 701",
            "city": "Milwaukie",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972223625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptaylor791191@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9205 SW Barnes Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptaylor791191@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "10150 SE 32nd Ave",
            "city": "Milwaukie",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972226516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptaylor791191@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4805 NE Glisan St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptaylor791191@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5251 NE Glisan St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972133052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Lynn Taylor, MS CCCSLP
• Barry Lynn Taylor
• Erin Leigh Taylor, OT
• Judy Louise Taylor, OCCU THERAPIST AST
• Lori Ann Taylor, O.T.R.
• Rachel Taylor, M.S., LPC
• Kathleen Marie Bell Tedlock, SPEECH LANGUAGE PATH
• Teen Challenge International Pacific Northwest Centers (Life Renewal - Portland Outpatient)
• Jenny Templeton
• Radu H Teodorescu, MD

• Psychiatry Physician in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.