NPIMap

Individual provider Active NPI

Leo J Daab, M.D.

  • Vascular Surgery Physician
  • Portland, OR
National Provider Identifier
1245274851
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD189626 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Mail Code: Op11
Portland, OR 97239
Phone
(503) 494-7593
Fax
(503) 346-8081
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 60404648 WA
Vascular Surgery Physician 2086S0129X MD189626 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Mail Code: Op11
Portland, OR 97239

Mailing address

3181 SW Sam Jackson Park Rd
Mail Code: Op11
Portland, OR 97239
Phone (503) 494-7593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 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
I20140121001473 WA Practitioner - Vascular Surgery 9739317728 Reassigns benefits to 2 organizations
I20180917001727 OR Practitioner - Vascular Surgery 9739317728 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Florida College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD189626ORMDVascular Surgery Physician
60404648WAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince May 7, 2019 Accepting new patients
Multicare Health System CurrentSince Dec 9, 2013 Accepting new patients
University Professional Services CurrentSince Aug 13, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients
University Professional Services CurrentSince Aug 13, 2018 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Dec 9, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince May 7, 2019 Accepting new patients
University Professional Services Past Accepting new patients
Oregon Health & Science University Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

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

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

3181 SW Sam Jackson Park Rd
#11
Portland, OR 97239
Phone (503) 494-7593

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

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

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: ldaab108979@direct.ohsu.edu

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1245274851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE: OP11",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-494-7593",
            "fax_number": "503-346-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE: OP11",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-494-7593",
            "fax_number": "503-346-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAAB",
        "first_name": "LEO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "60404648",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OR",
            "license": "MD189626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.