NPIMap

Individual provider Active NPI

Matthew Grace

  • Critical Care Medicine (Internal Medicine) Physician
  • Portland, OR
National Provider Identifier
1144724154
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
DO222984 Issued in OR
Practice address
1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone
(503) 413-7074
NPI assigned
Mar 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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
Critical Care Medicine (Internal Medicine) Physician 207RC0200X DO222984 OR Primary

Addresses

Primary practice location

1200 NW 23Rd Ave
Portland, OR 97210-2906

Mailing address

PO Box 3777
Portland, OR 97208-3777
Phone (508) 776-2463

Other practice location 1

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230613002608 AZ Practitioner - Internal Medicine 4082967039 Reassigns benefits to 1 organization
I20241213002970 OR Practitioner - Critical Care (Intensivists) 4082967039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200

Hospital & facility affiliations

  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Columbia Memorial Hospital Hospital, Astoria, OR, CCN 381320

Merit-based Incentive Payment System (MIPS)

Final score
84.74 of 100Reported as group
Quality
79.16
Promoting interoperability
100
Improvement activities
40
Cost
69.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO222984ORMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Dec 11, 2024 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Dec 11, 2024 Accepting new patients
Sound Physicians Intensivists of Arizona, Inc Internal Medicine CurrentSince Jun 1, 2023 Accepting new patients
SMSJ Tucson Holdings LLC Past Accepting new patients
Legacy Emanuel Hospital & Health Center Past Accepting new patients

Locations

14200 W Celebrate Life Way
Goodyear, AZ 85338
Phone (623) 207-3000

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

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

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Organizations & group practices 5

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 12

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": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1144724154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "508-776-2463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NW 23RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102906",
            "telephone_number": "503-413-7074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 N Gantenbein Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97227",
            "country_code": "US",
            "telephone_number": "503-413-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACE",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "DO222984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.