NPIMap

Organization Active NPI

Oregon Health & Science University

Doing business as OHSU Health Family Medicine, East Portland

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
National Provider Identifier
1245093533
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OREGON HEALTH & SCIENCE UNIVERSITY
Doing business as
OHSU Health Family Medicine, East Portland
Practice address
10101 SE Main St Ste 1001
Portland, OR 97216-2456
Phone
(503) 346-6400
Fax
(503) 346-6330
NPI assigned
Jan 31, 2024
Last updated
Jun 16, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
OREGON HEALTH & SCIENCE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Authorized official

Name
Kelly Anne Smith
Title
VP Enterprise Revenue Cycle
Phone
(503) 494-4422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

10101 SE Main St Ste 1001
Portland, OR 97216-2456

Mailing address

1400 SW 5TH Ave Ste 500
Portland, OR 97201-5537
Phone (866) 617-6855

Other names 1

  • OHSU Health Family Medicine, East Portland Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050516000173 OR Part B Supplier - Clinic/Group Practice 1759328842 Receives reassigned benefits from 168 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Scappoose, OR
O20240610001025 OR Part A Provider - Federally Qualified Health Center (FQHC) 1759328842 Practice locations: Portland, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245093533. Details of each certification follow.

Federally qualified health center certification: CCN 381028

Legal name
OREGON HEALTH & SCIENCE UNIVERSITY
Doing business as
OHSU HEALTH FAMILY MEDICINE, EAST PORTLAND COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 15, 2024
Last certification
May 15, 2024
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Incorporated
Jul 1, 1995 in OR
Enrollment address
10101 SE Main St
Ste 1001
Portland, OR 97216-2456

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2302001Ohsu Health Family Medicine, East Portland10101 SE Main St, Suite #1001, Portland, OR 97216Provider-performed microscopyApr 2, 2028

National Provider Directory

National Provider Directory
Tax ID family
Oregon Health Science Univ3 organizations share this tax ID, including this one
Part of
Oregon Health Science Univ

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sandra L Catalan Individual Corporate OfficerSVP, Chief Accounting Officer Oct 30, 2017
Corporate DirectorSVP, Chief Accounting Officer Oct 30, 2017
W-2 Managing EmployeeSVP, Chief Accounting Officer Oct 30, 2017
Shereef M Elnahal Individual Corporate OfficerPresident, Ohsu Aug 11, 2025
Corporate DirectorPresident, Ohsu Aug 11, 2025
W-2 Managing EmployeePresident, Ohsu Aug 11, 2025
Oregon Health & Science University Organization, Portland, OR 5% Or Greater Direct Ownership Interest Feb 15, 2024 100%
Operational/Managerial Control Feb 15, 2024 100%
Kelly Smith Individual Corporate OfficerVice President, Enterprise Revenue Apr 5, 2021
Corporate DirectorVice President, Enterprise Revenue Apr 5, 2021
W-2 Managing EmployeeVP, Enterprise Revenue Cycle Apr 5, 2021

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781568000000",
    "number": "1245093533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SW 5TH AVE STE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015537",
            "telephone_number": "866-617-6855",
            "fax_number": "503-346-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 SE MAIN ST STE 1001",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162456",
            "telephone_number": "503-346-6400",
            "fax_number": "503-346-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON HEALTH & SCIENCE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OREGON HEALTH & SCIENCE UNIVERSITY",
        "enumeration_date": "2024-01-31",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "VP ENTERPRISE REVENUE CYCLE",
        "authorized_official_telephone_number": "503-494-4422"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OHSU Health Family Medicine, East Portland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.