NPIMap

Organization Active NPI

Oregon Weight Loss Surgery LLC

  • Specialist
  • Portland, OR
National Provider Identifier
1497760045
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
12694364 Issued in OR
Legal business name
OREGON WEIGHT LOSS SURGERY LLC
Practice address
825 NE 20TH Ave Ste 340
Portland, OR 97232-2275
Phone
(503) 227-5050
Fax
(503) 227-2462
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Authorized official

Name
Emma J Patterson, MDNPI 1174515431
Title
General Manager
Phone
(503) 227-5050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 12694364 OR Primary

Addresses

Primary practice location

825 NE 20TH Ave Ste 340
Portland, OR 97232-2275

Mailing address

825 NE 20TH Ave Ste 340
Portland, OR 97232-2275
Phone (503) 227-5050

Other identifiers 1

IdentifierTypeStateIssuer
DF6325OtherORRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070110000615 OR Part B Supplier - Clinic/Group Practice 9931109220 Receives reassigned benefits from 3 practitioners
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

1040 NW 22nd Ave
Ste 500
Portland, OR 97210
Phone (503) 227-5050

2073 Olympic St
Ste 102
Springfield, OR 97477
Phone (503) 227-5050

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1497760045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 NE 20TH AVE STE 340",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322275",
            "telephone_number": "503-227-5050",
            "fax_number": "503-227-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NE 20TH AVE STE 340",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322275",
            "telephone_number": "503-227-5050",
            "fax_number": "503-227-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON WEIGHT LOSS SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "EMMA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "503-227-5050",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "12694364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF6325",
            "state": "OR"
        }
    ],
    "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, 2020; 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.