NPIMap

Individual provider Active NPI

Lan Ban, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1134500358
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD189134 Issued in OR
Practice address
9135 SW Barnes Rd Ste 763
Portland, OR 97225-6777
Phone
(503) 216-8250
NPI assigned
Jun 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PG173562 OR
Internal Medicine Physician 207R00000X MD189134 OR Primary

Addresses

Primary practice location

9135 SW Barnes Rd Ste 763
Portland, OR 97225-6777

Mailing address

PO Box 3158
Portland, OR 97208-3158

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lban519693@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
I20181025001927 OR Practitioner - Internal Medicine 6608189816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services Oregon 1,423 clinicians
Providence Health and Services - Oregon 212 clinicians

Practice addresses (Care Compare)

12345 SW Horizon Blvd
Suite 57
Beaverton, OR 97007-9475
Phone (503) 216-8820

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-2213

Hospital & facility affiliations

  • Providence Home Health Home health agency, Portland, OR, CCN 387048
  • Providence Hospice Hospice, Portland, OR, CCN 381500
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Adventist Health Tillamook Hospital, Tillamook, OR, CCN 381317

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Internal Medicine Current Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Nov 4, 2020 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 4, 2020 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Oct 8, 2018 Accepting new patients
Providence Health & Services - Oregon Internal Medicine Past Accepting new patients

Locations

12345 SW Horizon Blvd
Ste 57
Beaverton, OR 97007
Phone (503) 216-8820

9135 SW Barnes Rd
Ste 763
Portland, OR 97225
Phone (503) 216-6050

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

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

9135 SW Barnes Rd
Ste 668
Portland, OR 97225
Phone (503) 216-8250

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

Interoperability endpoints

  • Direct secure messaging: lban519693@oc.providencedirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1134500358",
    "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": "9135 SW BARNES RD STE 763",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256777",
            "telephone_number": "503-216-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAN",
        "first_name": "LAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "PG173562",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD189134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lban519693@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9135 SW Barnes Rd Ste 763",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.