Active NPI
Elroy Y Jan, M.D.
- Hospitalist Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- MD26958
- Practice address
- 9205 SW Barnes Rd
Portland, OR 97225-6603 - Phone
- (503) 216-2906
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD26958 | OR | |
| Hospitalist Physician | 208M00000X | MD26958 | OR | Primary |
Addresses
Primary practice location
9205 SW Barnes Rd
Portland, OR 97225-6603
Mailing address
PO Box 3158
Portland, OR 97208-3158
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 213211 | Medicaid | OR | |
| P00464831 | Other | OR | RR MEDICARE - PHS |
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- University of Tennessee, HSC, College of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10150 SE 32ND Ave
Milwaukie, OR 97222-6516
Phone (503) 513-3613
1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250
1500 Division St
Oregon City, OR 97045-1527
Phone (503) 557-2136
5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480
9205 SW Barnes Rd
Portland, OR 97225-6603
9290 SE Sunnybrook Blvd
Suite 120
Clackamas, OR 97015-6802
Phone (503) 215-2110
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD26958 | OR | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services - Oregon | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services Oregon | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services Oregon | Current | Accepting new patients |
Locations
9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960
1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661
10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202
9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234
417 SW 117th Ave
Ste 210
Portland, OR 97225
Phone (503) 216-7000
1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250
5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480
Organizations & group practices 7
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.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
Internal Medicine
-
- General Practice Physician
- Lake Oswego, OR
- NPI 1023488343
-
- General Acute Care Hospital
- Milwaukie, OR
- NPI 1366536963
Internal Medicine
-
- Clinical Pathology Physician
- Portland, OR
- NPI 1831641745
Internal Medicine
-
- Obstetrics & Gynecology Physician
- Portland, OR
- NPI 1235534116
-
- Psychiatric Hospital Unit
- Milwaukie, OR
- NPI 1659751360
-
- Psychiatry Physician
- Portland, OR
- NPI 1760177737
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
-
- General Acute Care Hospital
- Milwaukie, OR
- NPI 1366536963
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626912000000",
"number": "1134212814",
"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": "9205 SW BARNES RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256603",
"telephone_number": "503-216-2906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAN",
"first_name": "ELROY",
"middle_name": "Y",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2021-07-22",
"certification_date": "2021-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD26958",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "OR",
"license": "MD26958",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "213211",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE - PHS",
"identifier": "P00464831",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.