Individual provider Active NPI

Shai D Rosenfeld, MD

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1386904837
Registry record updated Feb 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD1666004 Issued in OR
Practice address
4104 SE 82ND Ave
Ste 250
Portland, OR 97266-2954
Phone
(503) 215-9850
NPI assigned
May 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD1666004 OR Primary

Addresses

Primary practice location

4104 SE 82ND Ave
Ste 250
Portland, OR 97266-2954

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other identifiers 1

IdentifierTypeStateIssuer
500666194MedicaidOR

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
I20140326001093 OR Practitioner - Family Practice 9931340213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

5330 NE Glisan St
Portland, OR 97213-3069

Hospital & facility affiliations

  • Providence Home Health Home health agency, Portland, OR, CCN 387048
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD1666004ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Family Medicine Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 27, 2014 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 27, 2014 Accepting new patients
Providence Health & Services - Oregon Family Medicine Current Accepting new patients
Providence Health & Services - Oregon Family Medicine Past Accepting new patients

Locations

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500

5555 NE Elam Young Pkwy
Hillsboro, OR 97124
Phone (503) 216-1600

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

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

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

15640 NW Laidlaw Rd
Ste 102
Portland, OR 97229
Phone (503) 764-0100

1321 NE 99th Ave
Ste 100
Portland, OR 97220
Phone (503) 215-4050

4104 SE 82nd Ave
Ste 250
Portland, OR 97266
Phone (503) 215-9850

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

5330 NE Glisan St
Ste 100
Portland, OR 97213
Phone (503) 215-9700

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

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 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": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1386904837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 SE 82ND AVE",
            "address_2": "STE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662954",
            "telephone_number": "503-215-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENFELD",
        "first_name": "SHAI",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD1666004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500666194",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.