Active NPI
John Matthew Creasy, MD
- Surgical Oncology Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Oncology Physician
- License
- MD205855
- Practice address
- 4805 NE Glisan St Ste 11N
Portland, OR 97213-2933 - Phone
- (503) 215-8650
- NPI assigned
- Mar 26, 2012
- Last updated
- Apr 19, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD205855 | OR | |
| Surgical Oncology Physician | 2086X0206X | MD205855 | OR | Primary |
Addresses
Primary practice location
4805 NE Glisan St Ste 11N
Portland, OR 97213-2933
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494
Other practice location 1
4805 NE Glisan St Ste 6N60
Portland, OR 97213-2933
Phone (503) 281-0561
Other practice location 2
9155 SW Barnes Rd Ste 735
Portland, OR 97225-6634
Phone (503) 281-0561
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500795850 | Medicaid | OR | |
| 2182679 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | referringgmis@1243.direct.myezyaccess.com | The Oregon Clinic PC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Surgical Oncology
- Education
- Wake Forest University School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4805 NE Glisan St
Portland, OR 97213-2933
5050 NE Hoyt St
Suite 454
Portland, OR 97213-2984
Phone (503) 215-6405
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD205855 | OR | MD | Surgical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients |
Locations
200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550
1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538
1500 Division St
Oregon City, OR 97045
Phone (503) 646-1631
10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202
4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111
4805 NE Glisan St
Ste 11N
Portland, OR 97213
Phone (503) 215-1350
4805 NE Glisan St
Ste 6N40
Portland, OR 97213
Phone (503) 215-5696
4805 NE Glisan St
Ste 6N60
Portland, OR 97213
Phone (503) 281-0561
5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480
5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405
847 NE 19th Ave
Ste 300
Portland, OR 97232
9155 SW Barnes Rd
Ste 735
Portland, OR 97225
Phone (503) 281-0561
9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234
Organizations & group practices 14
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.
-
dba Providence Medical Group
- General Practice Physician
- Lake Oswego, OR
- NPI 1023488343
-
dba Providence Portland Medical Center
- General Acute Care Hospital
- Portland, OR
- NPI 1003991845
-
dba Providence St Vincent Medical Center
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
-
dba Providence Willamette Falls Medical Center
- General Acute Care Hospital
- Oregon City, OR
- NPI 1912282369
-
dba Providence Newberg Medical Center
- General Acute Care Hospital
- Newberg, OR
- NPI 1952482275
-
dba Providence Milwaukie Hospital
- General Acute Care Hospital
- Milwaukie, OR
- NPI 1366536963
-
dba Providence Willamette Falls Medical Center
- Clinical Pathology Physician
- Oregon City, OR
- NPI 1003368911
-
dba Providence Newberg Medical Center
- Clinical Pathology Physician
- Newberg, OR
- NPI 1174074868
-
dba Providence Medical Group
- Cardiovascular Disease Physician
- Tigard, OR
- NPI 1588981963
-
dba Providence Portland Medical Center
- Clinical Pathology Physician
- Portland, OR
- NPI 1740732650
-
dba Prov St. Vincent Medical Ctr
- Clinical Pathology Physician
- Portland, OR
- NPI 1831641745
-
dba Providence Portland Medical Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Portland, OR
- NPI 1396818993
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence Portland Medical Center
- General Acute Care Hospital
- Portland, OR
- NPI 1003991845
-
dba Providence St Vincent Medical Center
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
-
- Case Manager/Care Coordinator
- Portland, OR
- NPI 1891822995
Hospital
-
dba Providence Seaside Hospital
- Critical Access Hospital
- Seaside, OR
- NPI 1578500492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713484800000",
"number": "1336415140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "503-215-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4805 NE GLISAN ST STE 11N",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132933",
"telephone_number": "503-215-8650"
}
],
"practiceLocations": [
{
"address_1": "4805 NE Glisan St Ste 6N60",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972132933",
"country_code": "US",
"telephone_number": "503-281-0561",
"fax_number": "503-416-7377",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9155 SW Barnes Rd Ste 735",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972256634",
"country_code": "US",
"telephone_number": "503-281-0561",
"fax_number": "503-416-7377",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CREASY",
"first_name": "JOHN",
"middle_name": "MATTHEW",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-26",
"last_updated": "2024-04-19",
"certification_date": "2024-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OR",
"license": "MD205855",
"primary": false
},
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "OR",
"license": "MD205855",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500795850",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2182679",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "referringgmis@1243.direct.myezyaccess.com",
"affiliation": "Y",
"affiliationName": "The Oregon Clinic PC",
"address_1": "4805 NE Glisan St Ste 6N60",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972132933",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Apr 19, 2024; 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.