NPIMap

Individual provider Active NPI

Emily Smith, DO

  • Internal Medicine Physician
  • Beaverton, OR
National Provider Identifier
1285193508
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO221434 Issued in OR
Practice address
2725 SW Cedar Hills Blvd Ste 250
Beaverton, OR 97005-1469
Phone
(503) 415-4060
NPI assigned
Mar 16, 2019
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X DO221434 OR Primary

Addresses

Primary practice location

2725 SW Cedar Hills Blvd Ste 250
Beaverton, OR 97005-1469

Mailing address

PO Box 3777
Portland, OR 97208-3777
Phone (503) 413-3900

Other practice location 1

200 Mullins Dr
Lebanon, OR 97355-3983
Phone (541) 259-0235

Other names 1

  • Emily Bauer Former name

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
I20240718001498 OR Practitioner - Internal Medicine 7719387653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

2725 SW Cedar Hills Blvd
Suite 250
Beaverton, OR 97005-1344
Phone (503) 415-4060

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Jul 3, 2024 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Jul 3, 2024 Accepting new patients

Locations

2725 SW Cedar Hills Blvd
Ste 250
Beaverton, OR 97005
Phone (503) 413-4060

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1552694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1285193508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 SW CEDAR HILLS BLVD STE 250",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051469",
            "telephone_number": "503-415-4060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Mullins Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973553983",
            "country_code": "US",
            "telephone_number": "541-259-0235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EMILY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-16",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO221434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "BAUER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.