Individual provider Active NPI

Brian Pfeiffer, DO

  • Pediatrics Physician
  • Portland, OR
National Provider Identifier
1356746697
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101022719 Issued in MI
Practice address
3550 N Interstate Ave
Portland, OR 97227-1196
Phone
(503) 331-6593
Fax
(844) 303-0586
NPI assigned
Oct 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5101022719 MI Primary

Addresses

Primary practice location

3550 N Interstate Ave
Portland, OR 97227-1196

Mailing address

3550 N Interstate Ave
Portland, OR 97227-1196
Phone (503) 331-6593

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Northwest Permanente PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 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
I20201015001022 WA Practitioner - Pediatric Medicine 6204128887 Reassigns benefits to 1 organization
I20201023000464 OR Practitioner - Pediatric Medicine 6204128887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Western University of Health Sciences College of Dental Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

3500 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 813-2000

3550 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 813-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101022719MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Pediatrics CurrentSince Jul 27, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 27, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Pediatrics CurrentSince Jul 27, 2020 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3550 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: bpfeiffer522754@direct.hfhs.org

Organizations & group practices 3

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": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1356746697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 N INTERSTATE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271196",
            "telephone_number": "503-331-6593",
            "fax_number": "844-303-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 N INTERSTATE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271196",
            "telephone_number": "503-331-6593",
            "fax_number": "844-303-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFFER",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-29",
        "last_updated": "2022-02-10",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101022719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Northwest Permanente PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3550 N Interstate Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972271196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.