Individual provider Active NPI

Lori Siegal, M.D.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1376656561
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD21229 Issued in OR
Practice address
6410 NE Halsey Street
Suite 300
Portland, OR 97213-4742
Phone
(503) 215-2669
Fax
(503) 215-8465
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD21229 OR Primary
Internal Medicine Physician 207R00000X MD00045814 WA

Addresses

Primary practice location

6410 NE Halsey Street
Suite 300
Portland, OR 97213-4742

Mailing address

P.O. Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051219000839 OR Practitioner - Internal MedicinePractitioner - Other (Physician) 2062434095 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, San Francisco School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 Crater Lake Ave
Medford, OR 97504-6241
Phone (541) 732-6274

9205 SW Barnes Rd
Suite Mt2159
Portland, OR 97225-6603
Phone (503) 215-2669

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00045814WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince May 1, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 20, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Aug 20, 2013 Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 20, 2011 Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 20, 2011 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients

Locations

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

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

1235 NE 47th Ave
Ste 148
Portland, OR 97213
Phone (503) 215-4601

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

2701 NW Vaughn St
Ste 140
Portland, OR 97210
Phone (503) 499-5147

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

9427 SW Barnes Rd
Ste 593
Portland, OR 97225
Phone (503) 216-8670

6410 NE Halsey St
Ste 300
Portland, OR 97213
Phone (503) 215-2273

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

Organizations & group practices 6

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 1

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1376656561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 NE HALSEY STREET",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972134742",
            "telephone_number": "503-215-2669",
            "fax_number": "503-215-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGAL",
        "first_name": "LORI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD21229",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00045814",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.