NPIMap

Individual provider Active NPI

Benjamin Lee Brody, M.D.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1245243799
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OR MD23966 Issued in OR
Practice address
19500 SE Stark St.
Portland, OR 97233
Phone
(503) 669-3900
Fax
(503) 669-3998
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OR MD23966 OR Primary

Addresses

Primary practice location

19500 SE Stark St.
Portland, OR 97233

Mailing address

19500 SE Stark St.
Portland, OR 97233
Phone (503) 669-3900

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
I20041222000662 OR Practitioner - Internal Medicine 7517925472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Wisconsin, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Meridian Park HospitalGroup PAC ID 5092609842, 113 clinicians

Practice addresses (Care Compare)

1433 SE 1St Ave
Canby, OR 97013-6768
Phone (503) 525-7600

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Salem, OR, CCN 387136
  • Amedisys Home Health Care Home health agency, Portland, OR, CCN 387003
  • Assured Home Health Home health agency, Salem, OR, CCN 387093
  • Ageright Care at Home Home health agency, Milwaukie, OR, CCN 387151
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Legacy Silverton Medical Center Hospital, Silverton, OR, CCN 380029
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OR MD23966ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 19, 2009 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Nov 19, 2009 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Nov 14, 2016 Accepting new patients
Pacific Medical Group, PC Past Accepting new patients
Legacy Meridian Park Hospital PastSince Nov 14, 2016 Accepting new patients

Locations

1433 SE 1st Ave
Canby, OR 97013
Phone (503) 525-7600

1433 SE 1st Ave
Ste 101
Canby, OR 97013

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

19500 SE Stark St
Portland, OR 97233
Phone (503) 669-3900

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61288
  • Direct secure messaging: bbrody11957@direct.lhs.org

Organizations & group practices 5

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 10

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1245243799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19500 SE STARK ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97233",
            "telephone_number": "503-669-3900",
            "fax_number": "503-669-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SE STARK ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97233",
            "telephone_number": "503-669-3900",
            "fax_number": "503-669-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODY",
        "first_name": "BENJAMIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "OR MD23966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.