Michael David Lifson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO213666 Issued in OR

Practice address

831 NW Council Dr Ste 125
Gresham, OR 97030-3794

Phone

(503) 665-8176

Fax

(503) 665-8178

NPI assigned

Apr 3, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Chicago College of Osteopathy, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dupage Emergency Physicians Convenient Care LLCGroup PAC ID 6608840046, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Dupage Emergency Physicians Convenient Care LLC

  • Emergency Medicine Physician
  • Lemont, IL
  • NPI 1922000363

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917

  Family Medicine

  Medicare reassignment NPD
• Dupage Emergency Physicians LTD

  • Emergency Medicine Physician
  • Downers Grove, IL
  • NPI 1255323481
  Medicare reassignment
• Kingman Healthcare, Inc

  • Urgent Care Clinic/Center
  • Kingman, AZ
  • NPI 1760703805
  NPD
• Kingman Healthcare, Inc

  • Community/Retail Pharmacy
  • Kingman, AZ
  • NPI 1992286298
  NPD
• Kingman Healthcare, Inc

  • Specialist
  • Kingman, AZ
  • NPI 1689897787

  Family Medicine

  NPD (past)

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

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Downers Grove, IL
  • NPI 1578670543
  Care Compare affiliation

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1285196725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE STE 182",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 NW COUNCIL DR STE 125",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303794",
            "telephone_number": "503-665-8176",
            "fax_number": "503-665-8178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7447 W Talcott Ave Ste 182",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606313712",
            "country_code": "US",
            "telephone_number": "773-792-5155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIFSON",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.073621",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO213666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Aron Lieblick, DMD
• Lisa Lien, IBCLC
• Kimberly Anne Liepold, NP
• Aaron Michael Liere
• Lifespan Psychiatric Consulting, LLC
• Kinda Lilley-Karkos, MA
• Florice Lim
• Madison Limon
• Tammy Lin
• Zednia Carolina Linares, MS, RDN, LD

• Family Medicine Physician in Gresham, OR
• Providers in Gresham, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.