NPIMap

Individual provider Active NPI

Kent Michael Grewe, M.D.

  • Neurological Surgery Physician
  • Portland, OR
National Provider Identifier
1417922295
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD13969 Issued in OR
Practice address
501 N Graham St
Ste 545
Portland, OR 97227
Phone
(503) 288-5151
Fax
(503) 288-4942
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD13969 OR Primary

Addresses

Primary practice location

501 N Graham St
Ste 545
Portland, OR 97227

Mailing address

501 N Graham St
Ste 545
Portland, OR 97227
Phone (503) 288-5151

Other identifiers 3

IdentifierTypeStateIssuer
R00WCJVQAOtherORPTAN
004197MedicaidOR
001782001OtherORBLUE CROSS BLUE SHIELD

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
I20101103000403 OR Practitioner - Neurosurgery 7416030374 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Oregon Health Sciences University School of Medicine, 1983
Medicare assignment
May accept Medicare assignment
Group practices
TS Billings LLCGroup PAC ID 0143201954, 5 clinicians

Practice addresses (Care Compare)

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 528-0704

501 N Graham St
Suite 545
Portland, OR 97227-2003
Phone (503) 288-5151

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion37
Laminectomy or laminotomy (partial removal of spine bones)74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
TS Billings, LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

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

501 N Graham St
Ste 545
Portland, OR 97227
Phone (503) 288-5151

Organizations & group practices 2

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 10

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1417922295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "STE 545",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97227",
            "telephone_number": "503-288-5151",
            "fax_number": "503-288-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "STE 545",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97227",
            "telephone_number": "503-288-5151",
            "fax_number": "503-288-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWE",
        "first_name": "KENT",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OR",
            "license": "MD13969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "R00WCJVQA",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004197",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001782001",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.