Dirk Jacob Van Leeuwen, M.D., PH.D., FAASLD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

CP206793 Issued in OR

Practice address

10000 SE Main St Ste 112
Portland, OR 97216-2441

Phone

(503) 255-3054

Fax

(503) 255-7651

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in ME, KY, WI3 enrollments

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 3

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine, Doctor of Philosophy

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.

• Mainehealth

  • General Acute Care Hospital
  • Biddeford, ME
  • NPI 1659392819

  ME

  Medicare reassignment NPD
• Owensboro Health Medical Group Inc

  • Surgery Physician
  • Greenville, KY
  • NPI 1235518242

  KY

  Medicare reassignment NPD
• Mainehealth

  • Skilled Nursing Facility
  • Sanford, ME
  • NPI 1447342209
  NPD
• Owensboro Health Medical Group Inc

  • Gastroenterology Physician
  • Owensboro, KY
  • NPI 1265747752

  Gastroenterology

  NPD
• Owensboro Health Medical Group Inc

  • Internal Medicine Physician
  • Owensboro, KY
  • NPI 1306700711
  NPD

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1205941309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST STE 112",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162441",
            "telephone_number": "503-255-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST STE 112",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162441",
            "telephone_number": "503-255-3054",
            "fax_number": "503-255-7651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Pleasant Valley Rd Ste 401",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423039774",
            "country_code": "US",
            "telephone_number": "270-417-7800",
            "fax_number": "270-417-7809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN LEEUWEN",
        "first_name": "DIRK",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D., FAASLD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "EMERGENT",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "CP206793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100220249",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dvanleeuwen360487@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Genevieve A Van Herk, PHARM.D.
• Jonathan Reuel Van Horn, PAC
• Laura Elizabeth Van Houten, LAURA VAN HOUTEN, MD
• Erin Victoria Sneddon Van Kleek, LCSW
• Aasher Van Laer, QMHA
• Lynn Marie Van Male, PH.D.
• Nicholas Van Marter-Sanders
• Richard Van Marter-Sanders
• George Leonard Van Meter, PA-C
• Sante L Van Meter, DA

• Gastroenterology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Gastroenterology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.