Oregon Health & Science University
Organization Active NPI Federally Qualified Health Center (FQHC) · Portland, OR
NPI 1245093533 · NPPES record last updated Jun 16, 2026
Key facts
- NPI
- 1245093533
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- OREGON HEALTH & SCIENCE UNIVERSITY
- 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
- Organization subpart
- Yes
- Parent organization (as reported)
- OREGON HEALTH & SCIENCE UNIVERSITY
Authorized official
- Name
- Kelly Anne Smith
- Title
- VP Enterprise Revenue Cycle
- Phone
- (503) 494-4422
Owners & managing parties with NPI records 10
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 2
Facilities with the same owner 6
Practitioners 98
-
Allison Foxx, PA-C
-
Shana R Green, PMHNP-BC/ ANP-BC
-
Bradley E Probst, MN FNP
-
Mary C Regan, PA-C
-
Shannon Lee Smith, PMHNP, MPH
-
Chethiya Weligodapola, PA-C
-
Dominic Francis Caruso, M.D.
-
Aimee Alejandre, PA-C
-
Gabriel K Andeen, MD
-
Mary E Bartlett, APRN
-
Molly Benoit, MD
-
Emma Rose Brooks, MD
-
Keevin Bybee, MD
-
Rebecca E Cantone, M.D.
-
Adrienne Cardiel, QMHP, MSW, LCSW
-
David James Casey, LCSW
-
Valerie Lynn Cecil, FNP
-
Matthew G Chan, MD
-
Jennifer Cogburn, MD
-
Clifford Coleman, MD, MPH
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D2302001 | Ohsu Health Family Medicine, East Portland | Provider-performed microscopy | Apr 2, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OR
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
- Government · Non-profit
- Incorporated
- Jul 1, 1995 in OR
- Enrollment address
- 10101 SE Main St
Ste 1001
Portland, OR 97216-2456
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Sandra L Catalan |
Corporate Officer |
Oct 30, 2017 | |
| Corporate Director |
Oct 30, 2017 | ||
| W-2 Managing Employee |
Oct 30, 2017 | ||
| Shereef M Elnahal |
Corporate Officer |
Aug 11, 2025 | |
| Corporate Director |
Aug 11, 2025 | ||
| W-2 Managing Employee |
Aug 11, 2025 | ||
| Oregon Health & Science University |
5% Or Greater Direct Ownership Interest | Feb 15, 2024 | 100% |
| Operational/Managerial Control | Feb 15, 2024 | 100% | |
| Kelly Smith |
Corporate Officer |
Apr 5, 2021 | |
| Corporate Director |
Apr 5, 2021 | ||
| W-2 Managing Employee |
Apr 5, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Oregon Health Science Univ
- Part of
- Oregon Health Science Univ
Locations
10101 SE Main St
Portland, OR 97216
Phone (503) 253-3268
51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
- OHSU Health Family Medicine, East Portland
Other providers in Portland, OR
- Oregon Family Care Home
- Oregon Fertility Institute Laboratory
- Oregon Fertility Institute, LLC
- Oregon Health & Science University
- Oregon Health & Science University
- Oregon Health & Science University
- Oregon Health & Science University
- Oregon Health & Science University
- Oregon Health & Science University
- Oregon Health & Science University
All providers in Portland, OR · Federally Qualified Health Center (FQHC) in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.