NPIMap

Individual provider Active NPI

Tricia N Jesperson, DO

  • Nephrology Physician
  • Portland, OR
National Provider Identifier
1174777973
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
DO156294 Issued in OR
Practice address
4224 NE Halsey St Ste 300
Portland, OR 97213-1568
Phone
(503) 235-5509
Fax
(503) 235-5335
NPI assigned
Nov 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X OP60277405 WA
Nephrology Physician 207RN0300X DOS-2038 HI
Nephrology Physician 207RN0300X DO156294 OR Primary

Addresses

Primary practice location

4224 NE Halsey St Ste 300
Portland, OR 97213-1568

Mailing address

PO Box 3068
Portland, OR 97208-3068
Phone (503) 229-7976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, HI2 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
I20120813000498 OR Practitioner - NephrologyPractitioner - Internal Medicine 0749436442 Reassigns benefits to 1 organization
I20200207000630 HI Practitioner - Nephrology 0749436442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Renal Clinic IncGroup PAC ID 8628065836, shared by 3 NPIs, 39 clinicians

Practice addresses (Care Compare)

4224 NE Halsey St
Suite 300
Portland, OR 97213-1568
Phone (503) 235-5509

633 Ponahawai St
Suite 103
Hilo, HI 96720-7601
Phone (808) 481-2300

Hospital & facility affiliations

  • FMC Clackamas Kidney Center Dialysis facility, Clackamas, OR, CCN 382526
  • FMC Hilltop Dialysis Dialysis facility, Oregon City, OR, CCN 382570
  • DaVita Lake Road Dialysis Dialysis facility, Milwaukie, OR, CCN 382534
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Adventist Health Portland Hospital, Portland, OR, CCN 380060
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DOS-2038HIMDNephrology Physician
OP60277405WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Renal Clinic, Inc. Nephrology CurrentSince Dec 18, 2019 Accepting new patients
Northwest Renal Clinic, Inc. Nephrology Current Accepting new patients
Northwest Renal Clinic, Inc. Nephrology CurrentSince Sep 1, 2012 Accepting new patients
Northwest Renal Clinic, Inc. Nephrology CurrentSince Sep 1, 2012 Accepting new patients
Northwest Renal Clinic, Inc. Nephrology Past Accepting new patients
Rose City Dialysis, LLC PastSince Feb 7, 2017 Accepting new patients

Locations

633 Ponahawai St
Ste 103
Hilo, HI 96720
Phone (808) 481-2300

105 Maui Lani Pkwy
Ste 100
Wailuku, HI 96793
Phone (808) 244-9555

12550 SE 93rd Ave
Ste 250
Clackamas, OR 97015
Phone (503) 654-1153

10201 SE Main St
Ste 27
Portland, OR 97216
Phone (503) 256-0877

1130 NW 22nd Ave
Ste 640
Portland, OR 97210
Phone (503) 229-7976

4224 NE Halsey St
Ste 300
Portland, OR 97213
Phone (503) 235-5509

Networks

  • HI PPO

Interoperability endpoints

  • Direct secure messaging: tjesperson37093@direct.acumenmd.com
  • Direct secure messaging: tjesperson154534@direct.ohsu.edu

Organizations & group practices 6

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 9

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": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1174777973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3068",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083068",
            "telephone_number": "503-229-7976",
            "fax_number": "503-274-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 NE HALSEY ST STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131568",
            "telephone_number": "503-235-5509",
            "fax_number": "503-235-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESPERSON",
        "first_name": "TRICIA",
        "middle_name": "N",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "OP60277405",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "HI",
            "license": "DOS-2038",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OR",
            "license": "DO156294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.