Bradley Garrett Olson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD177926 Issued in OR

Practice address

2800 N Vancouver Ave
Ste 165
Portland, OR 97227-1630

Phone

(503) 413-2902

Fax

(503) 413-5220

NPI assigned

Jun 16, 2006

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bolson144744@direct.lhs.org

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.

• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Medicare reassignment NPD
• Legacy Emanuel Hospital & Health Center

  dba Apothecary at Emanuel Hospital

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1417977976
  NPD
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027

  Pediatrics

  NPD

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472256000000",
    "number": "1154365369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N VANCOUVER AVE",
            "address_2": "STE 165",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271630",
            "telephone_number": "503-413-2902",
            "fax_number": "503-413-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N VANCOUVER AVE",
            "address_2": "STE 165",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271630",
            "telephone_number": "503-413-2902",
            "fax_number": "503-413-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "BRADLEY",
        "middle_name": "GARRETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2016-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD177926",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "206363",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01757060",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Olson
• Andrea Olson I
• Andrew Olson
• Barry Dean Olson, MD
• Bradley Olson
• Brenda Ann Olson, MD
• Cathy B Olson
• Christine Olson, DMD
• David Raymond Olson
• Deanna J Olson, MS, AUD

• Pediatrics Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.