NPIMap

Individual provider Active NPI

Stephen M Mitchell, DO

  • Endocrinology, Diabetes & Metabolism Physician
  • Portland, OR
National Provider Identifier
1164521654
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
DO201650 Issued in OR
Practice address
4805 NE Glisan St Ste 6N40
Portland, OR 97213-2933
Phone
(503) 215-6601
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X OP60077530 WA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X DO201650 OR Primary

Addresses

Primary practice location

4805 NE Glisan St Ste 6N40
Portland, OR 97213-2933

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

9155 SW Barnes Rd Ste 638
Portland, OR 97225-6633
Phone (503) 216-7000

Other identifiers 1

IdentifierTypeStateIssuer
8541617MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smitchell1400725@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
I20070227000452 OR Practitioner - EndocrinologyPractitioner - Internal Medicine 1355342353 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Arizona College of Osteopathic Medicine Mid Western University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

9155 SW Barnes Rd
Suite 638
Portland, OR 97225-6633
Phone (503) 216-7000

Hospital & facility affiliations

  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
  • Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318
  • Adventist Health Portland Hospital, Portland, OR, CCN 380060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO201650ORMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2021 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 21, 2020 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2021 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2021 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 21, 2020 Accepting new patients
Providence Health & Services - Oregon Endocrinology, Diabetes & Metabolism Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500

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

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

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

9155 SW Barnes Rd
Ste 638
Portland, OR 97225
Phone (503) 216-7000

4805 NE Glisan St
Ste 6N40
Portland, OR 97213
Phone (503) 215-5696

1321 NE 99th Ave
Ste 100
Portland, OR 97220
Phone (503) 215-4050

5211 NE Glisan St
Bldg C
Portland, OR 97213
Phone (503) 215-3081

Interoperability endpoints

  • Direct secure messaging: smitchell1400725@oc.providencedirect.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1164521654",
    "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",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST STE 6N40",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-6601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9155 SW Barnes Rd Ste 638",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256633",
            "country_code": "US",
            "telephone_number": "503-216-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WA",
            "license": "OP60077530",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OR",
            "license": "DO201650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8541617",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smitchell1400725@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5211 NE Glisan St Bldg C",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972133052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.