Individual provider Active NPI

Justin John Leitenberger, M.D.

  • MOHS-Micrographic Surgery Physician
  • Portland, OR
National Provider Identifier
1508027616
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
MD157327 Issued in OR
Practice address
3303 S Bond Ave
Portland, OR 97239-4501
Phone
(503) 418-3376
Fax
(503) 494-6968
NPI assigned
Jun 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD157327 OR
MOHS-Micrographic Surgery Physician 207ND0101X MD157327 OR Primary

Addresses

Primary practice location

3303 S Bond Ave
Portland, OR 97239-4501

Mailing address

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 418-3376

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
I20120724000509 OR Practitioner - Micrographic Dermatologic Surgery (MDS)Practitioner - Dermatology 4981860624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Micrographic Dermatologic Surgery (MDS)Also: Dermatology
Education
University of Texas Medical School at Houston, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

6355 NE Cornell Rd
Suite 100
Hillsboro, OR 97124-5434
Phone (503) 494-1983

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision126
Removal of skin lesions22
Removal of skin cancer624
Skin biopsy32

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jul 2, 2012 Accepting new patients
University Professional Services CurrentSince Jul 2, 2012 Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients
University Professional Services Past Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

6355 NE Cornell Rd
Hillsboro, OR 97124
Phone (503) 418-3376

3181 SW Sam Jackson Park Rd
#16D
Portland, OR 97239
Phone (503) 494-3376

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

1935 E 19th St
Ste 110
The Dalles, OR 97058
Phone (541) 296-7280

Interoperability endpoints

  • Direct secure messaging: jleitenbergermd13354@direct.ohsu.edu

Organizations & group practices 5

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 1

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": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1508027616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-418-3376",
            "fax_number": "503-494-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-418-3376",
            "fax_number": "503-494-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITENBERGER",
        "first_name": "JUSTIN",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "MD157327",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "OR",
            "license": "MD157327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.