Active NPI
Brian Le
- Rheumatology Physician
- Portland, OR
National Provider Identifier
1487069795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 90424
- Practice address
- 3181 SW Sam Jackson Park Rd # Op-09
Portland, OR 97239 - Phone
- (503) 494-7729
- Fax
- (503) 494-1022
- NPI assigned
- Jun 25, 2014
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 6800 | GA | |
| Rheumatology Physician | 207RR0500X | 90424 | GA | Primary |
| Rheumatology Physician | 207RR0500X | MD193296 | OR |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd # Op-09
Portland, OR 97239
Mailing address
3181 SW Sam Jackson Park Rd # Op-09
Portland, OR 97239-3098
Phone (503) 494-7729
Other practice location 1
1120 15th St
Augusta, GA 30912-0004
Phone (706) 721-2423
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6800 | GA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Au Medical Associates Inc | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients |
Locations
1120 15th St
Augusta, GA 30912
Phone (706) 721-3873
1120 15th St
Ste OR6000
Augusta, GA 30912
Phone (706) 721-3813
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.
-
- Multi-Specialty Clinic/Center
- Augusta, GA
- NPI 1841230620
-
- Durable Medical Equipment & Medical Supplies
- Augusta, GA
- NPI 1114574126
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637193600000",
"number": "1487069795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD # OP-09",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393098",
"telephone_number": "503-494-7729",
"fax_number": "503-494-1022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD # OP-09",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "503-494-7729",
"fax_number": "503-494-1022"
}
],
"practiceLocations": [
{
"address_1": "1120 15th St",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "309120004",
"country_code": "US",
"telephone_number": "706-721-2423",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LE",
"first_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-25",
"last_updated": "2021-11-18",
"certification_date": "2021-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "6800",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "GA",
"license": "90424",
"primary": true
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "OR",
"license": "MD193296",
"primary": false
}
],
"identifiers": [],
"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 Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.