Individual provider Active NPI

Casey Elizabeth Ferguson, M.D.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1447375233
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD27372 Issued in OR
Practice address
4805 NE Glisan St
Ste BG05
Portland, OR 97213-2933
Phone
(503) 215-2392
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X MD27372 OR
Hospitalist Physician 208M00000X MD27372 OR
Internal Medicine Physician 207R00000X MD27372 OR Primary

Addresses

Primary practice location

4805 NE Glisan St
Ste BG05
Portland, OR 97213-2933

Mailing address

1027 E Burnside St
Portland, OR 97214-1328
Phone (503) 239-8400

Other practice location 1

2367 S Roosevelt Dr
Seaside, OR 97138-6550
Phone (971) 320-3130

Other identifiers 3

IdentifierTypeStateIssuer
243094MedicaidOR
P00464817OtherORRAILROAD MEDICARE - PROVIDENCE
92075355MedicaidNM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cferguson91570@oc.providencedirect.org

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
I20080219000510 OR Practitioner - HospitalistPractitioner - Internal Medicine 1759373319 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Texas Medical Branch at Galveston, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

24800 SE Stark St
Gresham, OR 97030-3378
Phone (503) 413-8988

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Internal Medicine CurrentSince May 21, 2017 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Aug 4, 2019 Accepting new patients
Coda, Inc. CurrentSince Feb 9, 2020 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince May 18, 2023 Accepting new patients
Coda, Inc. CurrentSince Aug 8, 2021 Accepting new patients
Providence Health & Services Oregon CurrentSince May 21, 2017 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

4805 NE Glisan St
Ste BG5
Portland, OR 97213
Phone (503) 215-2392

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1027 E Burnside St
Portland, OR 97214

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

2367 S Roosevelt Dr
Seaside, OR 97138
Phone (971) 320-3130

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: cferguson91570@oc.providencedirect.org

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 6

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1447375233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "address_2": "STE BG05",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-2392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2367 S Roosevelt Dr",
            "address_purpose": "LOCATION",
            "city": "Seaside",
            "state": "OR",
            "postal_code": "971386550",
            "country_code": "US",
            "telephone_number": "971-320-3130",
            "fax_number": "503-254-6396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "CASEY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OR",
            "license": "MD27372",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD27372",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD27372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243094",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - PROVIDENCE",
            "identifier": "P00464817",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92075355",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cferguson91570@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4805 NE Glisan St",
            "address_2": "STE BG05",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.