Betty Si Yuan Jiang

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

175989 Issued in OR

Practice address

17704 Jean Way Ste 102
Lake Oswego, OR 97035-5585

Phone

(503) 635-9221

NPI assigned

Apr 6, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

Duke University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Oswego Dermatology Group PCGroup PAC ID 6204808488, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lake Oswego Dermatology Group, PC

  • Dermatology Physician
  • Lake Oswego, OR
  • NPI 1710167689
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1194110288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17704 JEAN WAY STE 102",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355585",
            "telephone_number": "503-635-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17704 JEAN WAY STE 102",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355585",
            "telephone_number": "503-635-9221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Erwin Road",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "27710",
            "country_code": "US",
            "telephone_number": "919-684-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIANG",
        "first_name": "BETTY",
        "middle_name": "SI YUAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "175989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anika Lee Jatho
• Justin Ryan Jelen, D.C.
• Deniese Elaine Jensen Granville, DPM
• Anita Jensen, MS, CCC-SLP
• Tabitha Alana Jensen
• Jka Enterprises,Inc
• JMW Psychiatry MD LLC
• David Jocz, LPC
• John B. Holt, DMD, P.C.
• Meghan Johns, BCBA

• Dermatology Physician in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Dermatology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.