The Endocrine Clinic PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

MD019378 Issued in OR

Legal business name

THE ENDOCRINE CLINIC PC

Practice address

10000 SE Main St
Suite 403
Portland, OR 97216-2448

Phone

(503) 256-4096

Fax

(503) 256-0101

NPI assigned

Jun 24, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Tami L Prideaux

Title

Clinic Manager

Phone

(503) 256-4096

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diana C Negreanu, MD

  • Specialist
  • Portland, OR
  • NPI 1538282447
  Medicare reassignment Care Compare group NPD
• Gerald D Youker, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Portland, OR
  • NPI 1912908138
  Medicare reassignment Care Compare group NPD
• Olesya Petrenko, DO

  • Endocrinology, Diabetes & Metabolism Physician
  • Portland, OR
  • NPI 1427585942
  Medicare reassignment NPD
• Eric Ian Friedman, M.D.

  • Surgery Physician
  • Portland, OR
  • NPI 1932267333
  NPD (past)
• William Joseph Wood Jr., MD

  • Surgical Oncology Physician
  • Portland, OR
  • NPI 1881752293
  NPD (past)

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255367884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST",
            "address_2": "SUITE 403",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162448",
            "telephone_number": "503-256-4096",
            "fax_number": "503-256-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST",
            "address_2": "SUITE 403",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162448",
            "telephone_number": "503-256-4096",
            "fax_number": "503-256-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ENDOCRINE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRIDEAUX",
        "authorized_official_first_name": "TAMI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "503-256-4096",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OR",
            "license": "MD019378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in Portland, OR
• Providers in Portland, OR by specialty
• Endocrinology, Diabetes & Metabolism Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.