Individual provider Active NPI

Ian Richard Starr, M.D.

  • Psychiatry Physician
  • Portland, OR
National Provider Identifier
1174768865
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD158317 Issued in OR
Practice address
3716 NE MLK Jr Blvd
Portland, OR 97212-1111
Phone
(503) 288-8066
Fax
(503) 288-8168
NPI assigned
Dec 9, 2008
Last updated
Jan 14, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD158317 OR Primary

Addresses

Primary practice location

3716 NE MLK Jr Blvd
Portland, OR 97212-1111

Mailing address

3716 NE MLK Jr Blvd
Portland, OR 97212-1111
Phone (503) 288-8066

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
I20130403000632 OR Practitioner - Psychiatry 4688819121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Oregon Health Sciences University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifeworks NWGroup PAC ID 1850282575, 15 clinicians

Practice addresses (Care Compare)

14600 NW Cornell Rd
Portland, OR 97229-5442

3716 NE Martin Luther King Blvd
Portland, OR 97212-1111
Phone (503) 288-8066

971 SW Walnut St
Hillsboro, OR 97123-5651
Phone (503) 640-5297

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD158317ORMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeworks NW CurrentSince Jan 8, 2013 Accepting new patients

Locations

971 SW Walnut St
Hillsboro, OR 97123
Phone (503) 640-5297

10202 SE 32nd Ave
Ste 701
Portland, OR 97222
Phone (503) 496-3201

3716 NE Mlk Jr Blvd
Portland, OR 97212
Phone (503) 228-8066

5415 SW Westgate Dr
Portland, OR 97221
Phone (503) 645-9010

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1174768865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 NE MLK JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121111",
            "telephone_number": "503-288-8066",
            "fax_number": "503-288-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 NE MLK JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121111",
            "telephone_number": "503-288-8066",
            "fax_number": "503-288-8168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARR",
        "first_name": "IAN",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-09",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD158317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.