NPIMap

Individual provider Active NPI

Brian Park

  • Vascular & Interventional Radiology Physician
  • Portland, OR
National Provider Identifier
1376961896
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD198267 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-7660
Fax
(503) 494-4258
NPI assigned
Apr 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MT208253 PA
Vascular & Interventional Radiology Physician 2085R0204X MD61228625 WA
Vascular & Interventional Radiology Physician 2085R0204X 213551 AK
Vascular & Interventional Radiology Physician 2085R0204X MD198267 OR Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd.
SJH-2
Portland, OR 97239-3011
Phone (503) 494-7660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200715002683 OR Practitioner - Interventional Radiology 9335446830 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
New York University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Mid-Columbia Medical Center Hospital, The Dalles, OR, CCN 380001
  • Columbia Memorial Hospital Hospital, Astoria, OR, CCN 381320

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT208253PAMDDiagnostic Radiology Physician
213551AKMDVascular & Interventional Radiology Physician
MD198267ORMDVascular & Interventional Radiology Physician
MD61228625WAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Meridian Park Hospital CurrentSince Sep 1, 2022 Accepting new patients
University Professional Services Current Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Dec 16, 2020 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Dec 16, 2020 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Dec 16, 2020 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Dec 16, 2020 Accepting new patients
University Professional Services CurrentSince Jul 1, 2020 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Legacy Meridian Park Hospital CurrentSince Sep 1, 2022 Accepting new patients
University Professional Services CurrentSince Jul 1, 2020 Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Dec 16, 2020 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Dec 16, 2020 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

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
#2
Portland, OR 97239
Phone (503) 494-4910

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Interoperability endpoints

  • Direct secure messaging: bpark123575@direct.ohsu.edu

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1376961896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD.",
            "address_2": "SJH-2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7660",
            "fax_number": "503-494-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7660",
            "fax_number": "503-494-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT208253",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD61228625",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AK",
            "license": "213551",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OR",
            "license": "MD198267",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.