NPIMap

Individual provider Active NPI

James Lee Gendreau, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1265056626
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD222647 Issued in OR
Practice address
1130 NW 22ND Avenue, Ste 640
Portland, OR 97210
Phone
(503) 229-7976
Fax
(503) 274-4867
NPI assigned
Jun 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD222647 OR
Internal Medicine Physician 207R00000X MD222647 OR Primary

Addresses

Primary practice location

1130 NW 22ND Avenue, Ste 640
Portland, OR 97210

Mailing address

PO Box 3068
Portland, OR 97208-3068
Phone (503) 229-7976

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
I20250227001264 OR Practitioner - Internal MedicinePractitioner - Hospitalist 8325460165 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Renal Clinic IncGroup PAC ID 8628065836, 39 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 640
Portland, OR 97210-2993
Phone (503) 229-7976

4805 NE Glisan St
Portland, OR 97213-2933

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Internal Medicine Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Mar 10, 2025 Accepting new patients
Providence Health & Services Oregon CurrentSince Mar 10, 2025 Accepting new patients
Northwest Renal Clinic, Inc. Nephrology CurrentSince Jan 1, 2026 Accepting new patients
Northwest Renal Clinic, Inc. Nephrology CurrentSince Jan 1, 2026 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Mar 10, 2025 Accepting new patients
Providence Health & Services Oregon CurrentSince Mar 10, 2025 Accepting new patients

Locations

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

5050 NE Hoyt St
Ste 540
Portland, OR 97213
Phone (503) 215-6600

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

1130 NW 22nd Ave
Ste 640
Portland, OR 97210
Phone (503) 229-7976

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

Interoperability endpoints

  • Direct secure messaging: jgendreau1264737@oc.providencedirect.org

Organizations & group practices 9

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 8

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": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1265056626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3068",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083068",
            "telephone_number": "503-229-7976",
            "fax_number": "503-274-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVENUE, STE 640",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-229-7976",
            "fax_number": "503-274-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDREAU",
        "first_name": "JAMES",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-02",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OR",
            "license": "MD222647",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD222647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.