Northwestern Neurological Assoc PC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

NORTHWESTERN NEUROLOGICAL ASSOC PC

Practice address

501 N Graham St
Suite 545
Portland, OR 97227-1654

Phone

(503) 288-5151

Fax

(503) 288-4942

NPI assigned

Feb 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kent Michael Grewe, MDNPI 1417922295

Title

Owner

Phone

(503) 288-5151

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Northwestern Neurological Associates PC Other name

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kent Michael Grewe, M.D.

  • Neurological Surgery Physician
  • Portland, OR
  • NPI 1417922295
  Medicare reassignment Authorized official
• Lorraine Walburga Gohman, PA-C

  • Surgical Physician Assistant
  • Portland, OR
  • NPI 1013161405
  Medicare reassignment
• David H Clements, PA-C

  • Physician Assistant
  • Nampa, ID
  • NPI 1114917168
  NPD (past)

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1447223466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE 545",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271654",
            "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": "SUITE 545",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271654",
            "telephone_number": "503-288-5151",
            "fax_number": "503-288-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN NEUROLOGICAL ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "GREWE",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-288-5151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "R0000WCJVQ",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001782000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004197",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwestern Neurological Associates PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Neurological Surgery Physician in Portland, OR
• Providers in Portland, OR by specialty
• Neurological Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.