NPIMap

Individual provider Active NPI

Gordon Johnson, MD

  • Hospitalist Physician
  • Gresham, OR
National Provider Identifier
1235103276
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD19750 Issued in OR
Practice address
24988 SE Stark St
Gresham, OR 97030-8324
Phone
(503) 331-2376
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD19750 OR Primary

Addresses

Primary practice location

24988 SE Stark St
Gresham, OR 97030-8324

Mailing address

3465 NE 36TH Ave
Portland, OR 97212-2756
Phone (503) 331-2376

Other identifiers 1

IdentifierTypeStateIssuer
150252MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040420000392 OR Practitioner - Internal Medicine 8820083603 Reassigns benefits to 5 organizations
I20210804002298 WA Practitioner - Internal Medicine 8820083603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians
Columbia Lutheran CharitiesGroup PAC ID 5294643359, shared by 8 NPIs, 110 clinicians

Practice addresses (Care Compare)

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

1015 Nw22Nd Ave
Suite 34
Portland, OR 97210-3025
Phone (503) 413-6376

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

1225 NE 2ND Ave
Portland, OR 97232-2003
Phone (503) 944-8000

2111 Exchange St
Astoria, OR 97103-3329
Phone (503) 325-4321

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-1122

Hospital & facility affiliations

  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
  • Columbia Memorial Hospital Hospital, Astoria, OR, CCN 381320
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Lutheran Charities Current Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Dec 15, 2015 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Jul 22, 2021 Accepting new patients
Legacy Salmon Creek Hospital Hospitalist CurrentSince Jul 22, 2021 Accepting new patients
Silverton Health Hospitalist CurrentSince Mar 20, 2020 Accepting new patients
Legacy Clinics LLC Hospitalist CurrentSince Sep 1, 1999 Accepting new patients
Silverton Health CurrentSince Mar 20, 2020 Accepting new patients
Silverton Health Current Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Dec 15, 2015 Accepting new patients
Columbia Lutheran Charities CurrentSince Feb 6, 2025 Accepting new patients
University Professional Services Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Locations

2111 Exchange St
Astoria, OR 97103
Phone (503) 325-4321

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

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

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

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

1040 NW 22nd Ave
Ste 168
Portland, OR 97210
Phone (503) 413-7022

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

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

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 11

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235103276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 NE 36TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122756",
            "telephone_number": "503-331-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24988 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308324",
            "telephone_number": "503-331-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD19750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150252",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.