Individual provider Active NPI

Liesa Blond Harte, M.D.

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1346482791
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J5545 Issued in TX
Practice address
1603 SE 34TH Ave
Portland, OR 97214-5078
Phone
(737) 226-3245
Fax
(800) 561-1896
NPI assigned
Apr 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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 J5545 TX Primary

Addresses

Primary practice location

1603 SE 34TH Ave
Portland, OR 97214-5078

Mailing address

1321 Upland Dr # 5803
Houston, TX 77043-4718
Phone (737) 226-3245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 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
I20090715000779 TX Practitioner - Family Practice 0143372532 Reassigns benefits to 1 organization
I20160419001975 NY Practitioner - Family Practice 0143372532 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Family Medicine Current Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Feb 16, 2016 Accepting new patients
Scott and White Clinic Family Medicine CurrentSince Mar 2, 2017 Accepting new patients
Scott & White Clinic Family Medicine CurrentSince Mar 2, 2017 Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Feb 16, 2016 Accepting new patients
Tri-Cities Community Health PastSince Aug 1, 2020 Accepting new patients
Tri Cities Community Health Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Tamre B. McClelland MD PA Family Medicine Past Accepting new patients
Tri-Cities Community Health PastSince Aug 1, 2020 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

315 W 57th St
New York, NY 10019
Phone (212) 315-2330

1345 Rxr Plz
Uniondale, NY 11556
Phone (516) 453-0435

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1346482791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 UPLAND DR # 5803",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770434718",
            "telephone_number": "737-226-3245",
            "fax_number": "800-561-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 SE 34TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145078",
            "telephone_number": "737-226-3245",
            "fax_number": "800-561-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTE",
        "first_name": "LIESA",
        "middle_name": "BLOND",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-01",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J5545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.