NPIMap

Individual provider Active NPI

Jeremy David Fields, MD

  • Vascular Neurology Physician
  • Portland, OR
National Provider Identifier
1366577983
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
A91800 Issued in CA
Practice address
3181 SW Sam Jackson Park Rd # L-226
Ohsu Neurosciences Critical Care
Portland, OR 97239-3011
Phone
(503) 418-1472
Fax
(503) 418-1495
NPI assigned
Feb 22, 2007
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X A91800 CA Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd # L-226
Ohsu Neurosciences Critical Care
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd # L-226
Ohsu Neurosciences Critical Care
Portland, OR 97239-3011
Phone (503) 418-1472

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 OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080829000190 OR Practitioner - NeurosurgeryPractitioner - NeurologyPractitioner - Critical Care (Intensivists) 9234237637 Reassigns benefits to 2 organizations
I20191104001459 WA Practitioner - Neurosurgery 9234237637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of California, San Francisco School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

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

2400 Lancaster Dr NE
Salem, OR 97305-1221
Phone (800) 813-2000

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2042

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
A91800CAMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Mar 11, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Jun 1, 2014 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Jun 1, 2014 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 28, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Mar 11, 2013 Accepting new patients
University of California SFGH Medical Group Past Accepting new patients
Kaiser Foundation Hospitals Past Accepting new patients
UCSF Medical Group Business Services Past Accepting new patients
University Anesthesiology Associates, LLC Past Accepting new patients
University of California SFGH Medical Group PastSince Dec 21, 2021 Accepting new patients

Locations

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

10100 SE Sunnyside Rd
Ofc
Clackamas, OR 97015
Phone (503) 285-9321

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3181 SW Sam Jackson Park Rd
#L226
Portland, OR 97239
Phone (503) 494-7587

500 N Columbia River Hwy
Ste 6
Saint Helens, OR 97051
Phone (503) 366-5101

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

Organizations & group practices 12

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.

Hospital & facility affiliations 5

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1366577983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # L-226",
            "address_2": "OHSU NEUROSCIENCES CRITICAL CARE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-1472",
            "fax_number": "503-418-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # L-226",
            "address_2": "OHSU NEUROSCIENCES CRITICAL CARE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-1472",
            "fax_number": "503-418-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "JEREMY",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "CA",
            "license": "A91800",
            "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": "10100 SE Sunnyside Rd",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970158970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.