Individual provider Active NPI

Nancy J Heisel, MD

  • Internal Medicine Physician
  • Lake Oswego, OR
National Provider Identifier
1134274129
Registry record updated Jan 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD171272 Issued in OR
Practice address
18010 SW McEwan Rd
Lake Oswego, OR 97035-7868
Phone
(503) 525-7500
NPI assigned
Jan 23, 2007
Last updated
Jan 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD171272 OR Primary
Internal Medicine Physician 207R00000X 218217 AK

Addresses

Primary practice location

18010 SW McEwan Rd
Lake Oswego, OR 97035-7868

Mailing address

5810 SW Luradel CT
Portland, OR 97219-5780
Phone (503) 308-0654

Other practice location 1

3100 Tongass Ave
Ketchikan, AK 99901-5746
Phone (907) 228-8300

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150731014732 OR Practitioner - Internal Medicine 1658469606 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

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
100 of 100Reported as group
Quality
92.23
Promoting interoperability
100
Improvement activities
40
Cost
100

Merit-based Incentive Payment System (MIPS)

Final score
79.12 of 100Reported as group
Quality
81.91
Promoting interoperability
100
Improvement activities
40
Cost
40.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218217AKMDInternal Medicine Physician
MD171272ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Meridian Park Hospital CurrentSince Sep 18, 2024 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Sep 11, 2023 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Sep 18, 2024 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Sep 11, 2023 Accepting new patients
Multnomah County Current Accepting new patients
Mulnomah County CurrentSince Sep 13, 2022 Accepting new patients
Northwest Medical Foundation of Tillamook Current Accepting new patients
Multnomah County CurrentSince Sep 13, 2022 Accepting new patients
Landmark Health of Oregon LLC PastSince Jul 15, 2015 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

18010 SW McEwan Rd
Lake Oswego, OR 97035
Phone (503) 525-7500

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

2020 SE 182nd Ave
Portland, OR 97233
Phone (503) 661-3439

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Portland, OR 97209
Phone (503) 988-3674

1000 3rd St
Tillamook, OR 97141
Phone (503) 251-6129

1000 3rd St
#M
Tillamook, OR 97141
Phone (503) 815-2260

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737158400000",
    "number": "1134274129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 SW LURADEL CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972195780",
            "telephone_number": "503-308-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18010 SW MCEWAN RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357868",
            "telephone_number": "503-525-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Tongass Ave",
            "address_purpose": "LOCATION",
            "city": "Ketchikan",
            "state": "AK",
            "postal_code": "999015746",
            "country_code": "US",
            "telephone_number": "907-228-8300",
            "fax_number": "907-228-8440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEISEL",
        "first_name": "NANCY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD171272",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "218217",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.