Individual provider Active NPI

Russell Westlyn Riggs, MD

  • General Practice Physician
  • Tigard, OR
National Provider Identifier
1356384838
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD22787 Issued in OR
Practice address
10250 SW Greenburg Rd
4 Lincoln Center, Suite 125
Tigard, OR 97223-5443
Phone
(503) 719-6783
Fax
(971) 327-6734
NPI assigned
Jun 13, 2006
Last updated
Jan 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD22787 OR
General Practice Physician 208D00000X MD22787 OR Primary

Addresses

Primary practice location

10250 SW Greenburg Rd
4 Lincoln Center, Suite 125
Tigard, OR 97223-5443

Mailing address

10250 SW Greenburg Rd
4 Lincoln Center, Suite 125
Tigard, OR 97223-5443
Phone (503) 719-6783

Other identifiers 1

IdentifierTypeStateIssuer
287942MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA, AZ3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20050512000453 OR Practitioner - Emergency Medicine 1658312343 Reassigns benefits to 1 organization
I20190411000946 WA Practitioner - Emergency Medicine 1658312343 Reassigns benefits to 1 organization
I20220104000606 AZ Practitioner - Emergency Medicine 1658312343 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD22787ORMDEmergency Medicine Physician
22787ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Joint Specialists LLC General Practice CurrentSince Jan 2, 2011 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

2141 E Broadway Rd
Ste 111
Tempe, AZ 85282
Phone (503) 719-6783

10250 SW Greenburg Rd
Ste 115
Tigard, OR 97223
Phone (503) 719-6783

10250 SW Greenburg Rd
Ste 125
Tigard, OR 97223
Phone (503) 719-6783

1918 152nd Ave NE
Bellevue, WA 98007
Phone (206) 486-3998

1918 152nd Ave NE
Ste 200
Bellevue, WA 98007
Phone (206) 486-3998

Interoperability endpoints

  • Direct secure messaging: russell.riggs@3959.securemail.prognocis.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1356384838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10250 SW GREENBURG RD",
            "address_2": "4 LINCOLN CENTER, SUITE 125",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235443",
            "telephone_number": "503-719-6783",
            "fax_number": "971-327-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10250 SW GREENBURG RD",
            "address_2": "4 LINCOLN CENTER, SUITE 125",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235443",
            "telephone_number": "503-719-6783",
            "fax_number": "971-327-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIGGS",
        "first_name": "RUSSELL",
        "middle_name": "WESTLYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD22787",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OR",
            "license": "MD22787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287942",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.