NPIMap

Individual provider Active NPI

John Tyler Thiesing, M.D.

  • Vascular & Interventional Radiology Physician
  • Portland, OR
National Provider Identifier
1225104599
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD27230 Issued in OR
Practice address
9205 SW Barnes Rd
Portland, OR 97225-6603
Phone
(503) 216-4830
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD27230 OR
Vascular & Interventional Radiology Physician 2085R0204X MD27230 OR Primary

Addresses

Primary practice location

9205 SW Barnes Rd
Portland, OR 97225-6603

Mailing address

PO Box 25184
Portland, OR 97298-0184
Phone (503) 292-9108

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jthiesing109871@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
I20080707000026 OR Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 7517039654 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Oregon Health Sciences University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Medical Imaging LLCGroup PAC ID 9335191543, 28 clinicians
Bridgeport Medical Imaging, LLCGroup PAC ID 3173670411, 28 clinicians
TRG, LLCGroup PAC ID 8820283617, 35 clinicians

Practice addresses (Care Compare)

10810 NE Cornell Rd
Suite 100
Hillsboro, OR 97124-9219
Phone (503) 216-8400

18040 Swlower Boones Ferry Rd
Suite 106
Tigard, OR 97224-7259
Phone (503) 216-8400

4805 NE Glisan St
Portland, OR 97213-2933

5050 NE Hoyt St
Suite 454
Portland, OR 97213-2984
Phone (503) 215-6405

9135 SW Barnes Rd
Suite 261
Portland, OR 97225-6784
Phone (503) 216-6300

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-2213

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD27230ORMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Medical Imaging LLC Diagnostic Radiology CurrentSince Jul 1, 2008 Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 14, 2015 Accepting new patients
Bridgeport Medical Imaging, LLC Diagnostic Radiology CurrentSince Feb 23, 2009 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 10, 2017 Accepting new patients
TRG, LLC Diagnostic Radiology CurrentSince Sep 1, 2010 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 10, 2017 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 10, 2017 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 14, 2015 Accepting new patients

Locations

10810 NE Cornell Rd
Ste 100
Hillsboro, OR 97124
Phone (503) 216-4399

1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538

11782 SW Barnes Rd
Portland, OR 97225
Phone (503) 214-5200

9400 SW Barnes Rd
Ste 300
Portland, OR 97225

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

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

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

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

16770 SW Edy Rd
Sherwood, OR 97140
Phone (503) 216-9600

12442 SW Scholls Ferry Rd
Tigard, OR 97223
Phone (503) 216-9200

18040 SW Lower Boones Ferry Rd
Ste 106
Tigard, OR 97224
Phone (503) 216-8400

Interoperability endpoints

  • Direct secure messaging: jthiesing109871@oc.providencedirect.org

Organizations & group practices 10

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.

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1225104599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25184",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972980184",
            "telephone_number": "503-292-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256603",
            "telephone_number": "503-216-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIESING",
        "first_name": "JOHN",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD27230",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OR",
            "license": "MD27230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jthiesing109871@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9205 SW Barnes Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.