NPIMap

Individual provider Active NPI

Richard Brad Cook, M.D.

  • Vascular Surgery Physician
  • Wilsonville, OR
National Provider Identifier
1184869448
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD154186 Issued in OR
Practice address
25030 SW Parkway Ave Ste 200
Wilsonville, OR 97070-9816
Phone
(971) 434-0080
Fax
(503) 946-3891
NPI assigned
Dec 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD154186 OR
Vascular Surgery Physician 2086S0129X MD154186 OR Primary

Addresses

Primary practice location

25030 SW Parkway Ave Ste 200
Wilsonville, OR 97070-9816

Mailing address

25030 SW Parkway Ave Ste 200
Wilsonville, OR 97070-9816
Phone (971) 434-0080

Other practice location 1

4400 NE Halsey St Bldg 1
Portland, OR 97213-1545
Phone (971) 434-0080

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rcook101464@oc.providencedirect.org

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
I20110824000244 OR Practitioner - Vascular Surgery 5496925794 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oregon Vascular Specialists LLCGroup PAC ID 8022386663, 11 clinicians

Practice addresses (Care Compare)

25030 SW Pkwy Ave
Suite 200
Wilsonville, OR 97070-9816
Phone (971) 434-0080

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)90
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD154186ORMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 26, 2017 Accepting new patients
Providence Health & Services - Oregon CurrentSince Feb 26, 2017 Accepting new patients
Oregon Vascular Specialists LLC Vascular Surgery CurrentSince Sep 16, 2024 Accepting new patients

Locations

1550 NE 27th St
Ste 100
Bend, OR 97701
Phone (541) 313-8111

4400 NE Halsey St
Bldg 1
Portland, OR 97213
Phone (503) 215-6556

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

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

610 Hawthorne Ave SE
Ste 250
Salem, OR 97301
Phone (503) 559-3312

25030 SW Parkway Ave
Ste 200
Wilsonville, OR 97070
Phone (503) 612-0498

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDIHDD
  • Direct secure messaging: richard.cook.p1@direct.grandronde.nextgenshare.com

Organizations & group practices 4

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 6

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": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1184869448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25030 SW PARKWAY AVE STE 200",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709816",
            "telephone_number": "971-434-0080",
            "fax_number": "503-946-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25030 SW PARKWAY AVE STE 200",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709816",
            "telephone_number": "971-434-0080",
            "fax_number": "503-946-3891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 NE Halsey St Bldg 1",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972131545",
            "country_code": "US",
            "telephone_number": "971-434-0080",
            "fax_number": "503-946-3891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "RICHARD",
        "middle_name": "BRAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-15",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD154186",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OR",
            "license": "MD154186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcook101464@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9427 SW Barnes Rd Ste 593",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

Verify at the official NPI Registry.