Active NPI
Gregory Buel McCoy, MD
- Urology Physician
- Portland, OR
National Provider Identifier
1447247416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MD13218
- Practice address
- 1130 NW 22ND Ave
Ste 535
Portland, OR 97210-2900 - Phone
- (503) 297-4999
- Fax
- (503) 796-9884
- NPI assigned
- Oct 4, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD13218 | OR | Primary |
Addresses
Primary practice location
1130 NW 22ND Ave
Ste 535
Portland, OR 97210-2900
Mailing address
847 NE 19TH Ave
Suite 300
Portland, OR 97232-2684
Phone (503) 963-2801
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A008 | Other | TRICARE | |
| C91743 | Other | PROVIDENCE HEALTH | |
| 003395008 | Other | BLUE CROSS OR ALL | |
| 930766376 | Other | ADVENTIST MEDICAL | |
| 7858004 | Medicaid | WA | |
| 1040765 | Medicaid | WA | |
| 109371 | Medicaid | OR | |
| 930766376 | Other | CAREOREGON | |
| M677A | Other | HEALTH NET | |
| 180133 | Medicaid | OR | |
| 003395000 | Other | BLUE CROSS OR ALL | |
| 128281 | Other | WA | DEPT OF LABOR A |
| 0079880 | Other | WA | DEPT OF LABOR A |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444089600000",
"number": "1447247416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "847 NE 19TH AVE",
"address_2": "SUITE 300",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322684",
"telephone_number": "503-963-2801",
"fax_number": "503-963-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 NW 22ND AVE",
"address_2": "STE 535",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972102900",
"telephone_number": "503-297-4999",
"fax_number": "503-796-9884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "GREGORY",
"middle_name": "BUEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-04",
"last_updated": "2015-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "OR",
"license": "MD13218",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "A008",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDENCE HEALTH",
"identifier": "C91743",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OR ALL",
"identifier": "003395008",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADVENTIST MEDICAL",
"identifier": "930766376",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7858004",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1040765",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109371",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREOREGON",
"identifier": "930766376",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "M677A",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "180133",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OR ALL",
"identifier": "003395000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR A",
"identifier": "128281",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR A",
"identifier": "0079880",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.