Individual provider Active NPI

Thomas Hyland Schaumberg, MD

  • Pulmonary Disease Physician
  • Portland, OR
National Provider Identifier
1174516827
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD15332 Issued in OR
Practice address
1111 NE 99TH Ave Ste 200
Portland, OR 97220-9442
Phone
(503) 963-3030
Fax
(503) 963-3140
NPI assigned
Aug 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD15332 OR Primary

Addresses

Primary practice location

1111 NE 99TH Ave Ste 200
Portland, OR 97220-9442

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other identifiers 2

IdentifierTypeStateIssuer
8154197MedicaidWA
066113MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referringpulm@1243.direct.myezyaccess.com The Oregon Clinic PC

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
I20040608000107 OR Practitioner - Pulmonary Disease 4688572258 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 23, 2018 Accepting new patients
The Oregon Clinic PC Pulmonary Disease CurrentSince Aug 1, 1998 Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 7, 2011 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
The Oregon Clinic, PC CurrentSince Aug 1, 1998 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 23, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 7, 2011 Accepting new patients

Locations

200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

1500 Division St
Oregon City, OR 97045
Phone (503) 646-1631

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

847 NE 19th Ave
Ste 300
Portland, OR 97232

1111 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 216-5435

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

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

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1174516827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 NE 99TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209442",
            "telephone_number": "503-963-3030",
            "fax_number": "503-963-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAUMBERG",
        "first_name": "THOMAS",
        "middle_name": "HYLAND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD15332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8154197",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066113",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referringpulm@1243.direct.myezyaccess.com",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "1111 NE 99th Ave Ste 200",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972209442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.