NPIMap

Individual provider Active NPI

Andrew Olsen, D.O.

  • Diagnostic Radiology Physician
  • Portland, OR
National Provider Identifier
1386088821
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DO187857 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone
(503) 418-0990
Fax
(503) 494-4982
NPI assigned
Apr 26, 2013
Last updated
Jun 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X DO187857 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 418-0990

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
I20180531001835 OR Practitioner - Diagnostic Radiology 3971868530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuality Medical Group LLCGroup PAC ID 7416173414, 289 clinicians

Practice addresses (Care Compare)

335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO187857ORMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tuality Medical Group LLC CurrentSince Jul 1, 2019 Accepting new patients
Tuality Healthcare Current Accepting new patients
Tuality Medical Group LLC CurrentSince Jul 1, 2019 Accepting new patients

Locations

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

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

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

Interoperability endpoints

  • Direct secure messaging: aolsen107251@direct.ohsu.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1386088821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-0990",
            "fax_number": "503-494-4982"
        },
        {
            "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": "97239",
            "telephone_number": "503-418-0990",
            "fax_number": "503-494-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "ANDREW",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-26",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "DO187857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.