Active NPI
Steven E Macdonald, MD
- Anesthesiology Physician
- Portland, OR
National Provider Identifier
1346264074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD14036
- Practice address
- 4361 SW Bertha Ave
Portland, OR 97239-1577 - Phone
- (503) 729-8966
- NPI assigned
- Jul 26, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD14036 | OR | Primary |
Addresses
Primary practice location
4361 SW Bertha Ave
Portland, OR 97239-1577
Mailing address
4361 SW Bertha Ave
Portland, OR 97239-1577
Phone (503) 729-8966
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1048834 | Medicaid | WA | |
| 050035231 | Other | OR | RR MEDICARE |
| 1346264074 | Medicaid | MT | |
| MD036OR | Medicaid | AK | |
| XPY197569 | Medicaid | CA | |
| 026997 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398297600000",
"number": "1346264074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4361 SW BERTHA AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972391577",
"telephone_number": "503-729-8966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4361 SW BERTHA AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972391577",
"telephone_number": "503-729-8966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDONALD",
"first_name": "STEVEN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2014-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OR",
"license": "MD14036",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1048834",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "050035231",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1346264074",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD036OR",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "XPY197569",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "026997",
"state": "OR"
}
],
"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 Apr 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.