NPIMap

Individual provider Active NPI

Jennifer Elizabeth Hines, D.O.

  • Pulmonary Disease Physician
  • Ypsilanti, MI
National Provider Identifier
1205274370
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
DO203618 Issued in OR
Practice address
5333 McAuley Dr RM 4001
Ypsilanti, MI 48197-1099
Phone
(734) 712-3980
Fax
(734) 712-3782
NPI assigned
Jun 11, 2013
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101021017 MI
Internal Medicine Physician 207R00000X 162822 OR
Pulmonary Disease Physician 207RP1001X DO203618 OR Primary

Addresses

Primary practice location

5333 McAuley Dr RM 4001
Ypsilanti, MI 48197-1099

Mailing address

PO Box 446
Ann Arbor, MI 48106-0446
Phone (734) 747-6766

Other practice location 1

3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 768-4906

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
I20210709002595 OR Practitioner - Pulmonary Disease 0547486730 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2013
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
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians
Legacy Mount Hood Medical CenterGroup PAC ID 3173515996, 58 clinicians
Silverton HealthGroup PAC ID 8921901877, 147 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711

1130 NW 22ND Ave
Suite 400
Portland, OR 97210-2971
Phone (503) 413-6722

19300 SW 65TH Ave
Tualatin, OR 97062-7706
Phone (503) 692-2500

2222 NW Lovejoy St
Suite 411
Portland, OR 97210-5102
Phone (503) 413-5702

24800 SE Stark St
Gresham, OR 97030-3378
Phone (503) 661-9150

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-8258

342 Fairview St
Silverton, OR 97381-1917
Phone (503) 525-7660

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101021017MIMDInternal Medicine Physician
162822ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Meridian Park Hospital CurrentSince Aug 16, 2021 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Aug 16, 2021 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Aug 16, 2021 Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Aug 16, 2021 Accepting new patients
Silverton Health CurrentSince Jun 16, 2022 Accepting new patients
Legacy Mount Hood Medical Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Aug 16, 2021 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Aug 16, 2021 Accepting new patients
Silverton Health Current Accepting new patients
Legacy Clinics LLC CurrentSince Jun 2, 2021 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Aug 16, 2021 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Silverton Health CurrentSince Jun 16, 2022 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Jun 2, 2021 Accepting new patients
Legacy Meridian Park Pediatric Rehab Past Accepting new patients

Locations

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1130 NW 22nd Ave
Ste 400
Portland, OR 97210
Phone (503) 413-6555

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2222 NW Lovejoy St
Ste 411
Portland, OR 97210
Phone (503) 413-5598

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

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

Interoperability endpoints

  • Direct secure messaging: jhines620515@direct.lhs.org

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1205274370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 446",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481060446",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR RM 4001",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971099",
            "telephone_number": "734-712-3980",
            "fax_number": "734-712-3782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303737",
            "country_code": "US",
            "telephone_number": "541-768-4906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINES",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101021017",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "162822",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "DO203618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.