Individual provider Active NPI

Stephen P Werner, D.O.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1184010027
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO199072 Issued in OR
Practice address
4805 NE Glisan St Ste BG05
Portland, OR 97213-2933
Phone
(503) 215-2392
NPI assigned
Apr 7, 2015
Last updated
Sep 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X DO199072 OR Primary

Addresses

Primary practice location

4805 NE Glisan St Ste BG05
Portland, OR 97213-2933

Mailing address

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

Other practice location 1

2020 Gravier St
Suite 602
New Orleans, LA 70112-2272
Phone (504) 568-4006

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
I20200728001399 OR Practitioner - Internal MedicinePractitioner - Emergency Medicine 6103126339 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Ohio University, College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 N Providence Dr
Newberg, OR 97132-7485
Phone (503) 537-5612

1003 N Providence Dr
Suite 325
Newberg, OR 97132-7521
Phone (503) 216-1661

4805 NE Glisan St
Portland, OR 97213-2933

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2020 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2020 Accepting new patients
Emergency Medicine Specialists LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

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

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

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

4805 NE Glisan St
Ste BG5
Portland, OR 97213
Phone (503) 215-2392

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1184010027",
    "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 BG05",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-2392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Gravier St",
            "address_2": "Suite 602",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122272",
            "country_code": "US",
            "telephone_number": "504-568-4006",
            "fax_number": "504-599-1453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WERNER",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO199072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.