Active NPI
Outside in
- Federally Qualified Health Center (FQHC)
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- OUTSIDE IN
- Practice address
- 6130 SE Foster Rd
Portland, OR 97206-3739 - Phone
- (503) 535-3800
- NPI assigned
- Mar 4, 2022
- Last updated
- Mar 10, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ericka Young
- Title
- Revenue Cycle Manager
- Phone
- (503) 535-3800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary |
Addresses
Primary practice location
6130 SE Foster Rd
Portland, OR 97206-3739
Mailing address
1132 SW 13TH Ave
Portland, OR 97205-1703
Phone (503) 535-3833
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170919002919 | OR | Part B Supplier - Clinic/Group Practice | 9638256662 |
Receives reassigned benefits from 17 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Portland, OR; Clackamas, OR |
| O20220621002557 | OR | Part A Provider - Federally Qualified Health Center (FQHC) | 9638256662 | Practice locations: Portland, OR |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1275280729. Details of each certification follow.
Federally qualified health center certification: CCN 381005
- Legal name
- OUTSIDE IN
- Organization structure
- Corporation
- Enrollment address
- 6130 SE Foster Rd
Portland, OR 97206-3739
Other NPIs with the same Medicare PAC ID 6
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Non Profit
- Federally Qualified Health Center (FQHC)
- Portland, OR
- NPI 1972124196
9638256662
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Non Profit
- Federally Qualified Health Center (FQHC)
- Portland, OR
- NPI 1972124196
O20170919002919
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 15
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Jodi Enos | Corporate Director | Feb 22, 2022 | 7% |
| Steve Jones | Corporate Director | Apr 1, 2019 | 8% |
| Christopher Machuca | Corporate Director | Jun 16, 2020 | 7% |
| Ericka Young | W-2 Managing Employee | Jan 21, 2020 | |
| Joe Chapman | Corporate Director | Apr 19, 2021 | 7% |
| Thomas Lee | Corporate Director | Jun 19, 2019 | 7% |
| Hannah Hoffman | Corporate Director | Apr 19, 2022 | 7% |
| John Karp-Evans | Corporate Director | Apr 19, 2021 | 7% |
| Yoana Molina Marcial | Corporate Director | Jun 1, 2020 | 7% |
| Scott Tidmore | Corporate Director | Apr 19, 2022 | 7% |
| Brian Weaver | Corporate Director | Oct 24, 2017 | 7% |
| Anni Zieler | W-2 Managing Employee | Dec 1, 2007 | |
| Laura Milne | Corporate Director | May 19, 2020 | 7% |
| Lucas Newman | Corporate Director | Apr 1, 2020 | 7% |
| Outside in | Operational/Managerial Control | Apr 1, 2022 | 100% |
Owners & managing parties with NPI records 6
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Federally Qualified Health Center (FQHC)
- Portland, OR
- NPI 1063230480
Operational/Managerial Control
-
- Federally Qualified Health Center (FQHC)
- Clackamas, OR
- NPI 1306594445
Operational/Managerial Control
-
- Federally Qualified Health Center (FQHC)
- Portland, OR
- NPI 1477005619
Operational/Managerial Control
-
- Federally Qualified Health Center (FQHC)
- Portland, OR
- NPI 1568401347
Operational/Managerial Control
-
- Federally Qualified Health Center (FQHC)
- Portland, OR
- NPI 1619663697
Operational/Managerial Control
-
dba Non Profit
- Federally Qualified Health Center (FQHC)
- Portland, OR
- NPI 1972124196
Operational/Managerial Control
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Ochin, Inc. | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 1, 2020 Aug 1, 2020 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Non Profit
- Federally Qualified Health Center (FQHC)
- Portland, OR
- NPI 1972124196
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Non Profit
- Federally Qualified Health Center (FQHC)
- Portland, OR
- NPI 1972124196
Outside in
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Portland, OR
- NPI 1831625011
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646352000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1646870400000",
"number": "1275280729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1132 SW 13TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051703",
"telephone_number": "503-535-3833",
"fax_number": "503-535-3868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6130 SE FOSTER RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972063739",
"telephone_number": "503-535-3800"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OUTSIDE IN",
"organizational_subpart": "NO",
"enumeration_date": "2022-03-04",
"last_updated": "2022-03-10",
"certification_date": "2022-03-10",
"status": "A",
"authorized_official_last_name": "YOUNG",
"authorized_official_first_name": "ERICKA",
"authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
"authorized_official_telephone_number": "503-535-3800"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.