Individual provider Active NPI

Josh Gepner, MD

  • Family Medicine Physician
  • Lake Oswego, OR
National Provider Identifier
1174778328
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD154668 Issued in OR
Practice address
412 A Ave Ste 200
Lake Oswego, OR 97034-3078
Phone
(503) 635-2496
Fax
(503) 635-2497
NPI assigned
Dec 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD154668 OR Primary

Addresses

Primary practice location

412 A Ave Ste 200
Lake Oswego, OR 97034-3078

Mailing address

PO Box 6689
Portland, OR 97228-6689

Other practice location 1

16180 SE Sunnyside Rd
Ste 102
Happy Valley, OR 97015-6379
Phone (503) 582-4900

Other identifiers 1

IdentifierTypeStateIssuer
500642083MedicaidOR

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
I20120302000153 OR Practitioner - Family Practice 9335308873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Warren Alpert Medical School of Brown University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Meridian Park HospitalGroup PAC ID 5092609842, 113 clinicians

Practice addresses (Care Compare)

412 A Ave
Lake Oswego, OR 97034-3075
Phone (503) 635-2496

Hospital & facility affiliations

  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Meridian Park Hospital CurrentSince Sep 25, 2017 Accepting new patients
Legacy Meridian Park Hospital PastSince Sep 25, 2017 Accepting new patients

Locations

412 A Ave
Ste 200
Lake Oswego, OR 97034
Phone 5036352496 ext. 7458

412 A Ave
Lake Oswego, OR 97034
Phone (503) 635-2496

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Interoperability endpoints

  • Direct secure messaging: jgepner19161@direct.lhs.org

Organizations & group practices 2

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 4

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": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1174778328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6689",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972286689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 A AVE STE 200",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343078",
            "telephone_number": "503-635-2496",
            "fax_number": "503-635-2497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16180 SE Sunnyside Rd",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Happy Valley",
            "state": "OR",
            "postal_code": "970156379",
            "country_code": "US",
            "telephone_number": "503-582-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEPNER",
        "first_name": "JOSH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-01",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD154668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500642083",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.