NPIMap

Individual provider Active NPI

Steven S Andersen, MD

  • Physical Medicine & Rehabilitation Physician
  • Portland, OR
National Provider Identifier
1184606295
Registry record updated Nov 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD16587 Issued in OR
Practice address
5050 NE Hoyt St
Ste 353
Portland, OR 97213-2991
Phone
(503) 230-2833
Fax
(503) 232-8223
NPI assigned
Nov 15, 2005
Last updated
Nov 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD16587 OR Primary

Addresses

Primary practice location

5050 NE Hoyt St
Ste 353
Portland, OR 97213-2991

Mailing address

PO Box 821350
Vancouver, WA 98682-0030
Phone (503) 283-5220

Other identifiers 1

IdentifierTypeStateIssuer
013651MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100812000058 OR Practitioner - Physical Medicine and Rehabilitation 9335204031 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Wayne State University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

5050 NE Hoyt St
Suite 611
Portland, OR 97213-2990
Phone (503) 215-8699

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16587ORMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2015 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jul 5, 2014 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2015 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 5, 2014 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2015 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

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

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

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

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

5050 NE Hoyt St
Ste 611
Portland, OR 97213
Phone (503) 215-0703

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

Interoperability endpoints

  • Direct secure messaging: sandersen132703@oc.providencedirect.org

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, 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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1184606295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 821350",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986820030",
            "telephone_number": "503-283-5220",
            "fax_number": "503-283-9527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "STE 353",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132991",
            "telephone_number": "503-230-2833",
            "fax_number": "503-232-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "STEVEN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OR",
            "license": "MD16587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013651",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.