Individual provider Active NPI

Petya Gueordjeva, M.D.

  • Family Medicine Physician
  • Beaverton, OR
National Provider Identifier
1346268059
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD25385 Issued in OR
Practice address
2935 SW Cedar Hills Blvd
Beaverton, OR 97005-1342
Phone
(503) 352-6000
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD25385 OR Primary

Addresses

Primary practice location

2935 SW Cedar Hills Blvd
Beaverton, OR 97005-1342

Mailing address

85 N 12TH Ave
PO Box 568
Cornelius, OR 97113-9029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 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

Enrollment IDStateProvider typePAC IDDetails
I20041222000765 OR Practitioner - Internal Medicine 1052379922 Reassigns benefits to 2 organizations
I20211210001183 WA Practitioner - Internal Medicine 1052379922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711

1015 Nw22Nd Ave
Suite 34
Portland, OR 97210-3025
Phone (503) 413-6376

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

24800 SE Stark St
Gresham, OR 97030-3378
Phone (503) 413-8988

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-1122

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 Medicine

State licenses

LicenseStateTypeSpecialty
MD25385ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Silverton Health CurrentSince Mar 20, 2020 Accepting new patients
Legacy Clinics LLC CurrentSince Feb 19, 2007 Accepting new patients
Legacy Clinics LLC Family Medicine CurrentSince Feb 19, 2007 Accepting new patients
Silverton Health Current Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Sep 2, 2021 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Sep 2, 2021 Accepting new patients
Silverton Health Family Medicine CurrentSince Mar 20, 2020 Accepting new patients
Klamath Walk in Care Center Inc. PastSince Jul 5, 2014 Accepting new patients

Locations

2725 SW Cedar Hills Blvd
Ste 200
Beaverton, OR 97005
Phone (503) 352-6000

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

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

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346268059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 N 12TH AVE",
            "address_2": "PO BOX 568",
            "city": "CORNELIUS",
            "state": "OR",
            "postal_code": "971139029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 SW CEDAR HILLS BLVD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051342",
            "telephone_number": "503-352-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEORDJEVA",
        "first_name": "PETYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD25385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.