Individual provider Active NPI

Samuel Loeb, M.D.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1508091521
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60285711 Issued in WA
Practice address
1030 NE Couch St
Portland, OR 97232-3067
Phone
(503) 239-8400
Fax
(503) 239-8406
NPI assigned
May 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD 60285711 WA
Internal Medicine Physician 207R00000X MD60285711 WA Primary

Addresses

Primary practice location

1030 NE Couch St
Portland, OR 97232-3067

Mailing address

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

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

State licenses

LicenseStateTypeSpecialty
MD 60285711WAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coda, Inc. CurrentSince Jun 5, 2022 Accepting new patients
Coda, Inc. CurrentSince Jun 5, 2022 Accepting new patients
University Professional Services PastSince Jun 5, 2022 Accepting new patients
University Professional Services PastSince Jun 5, 2022 Accepting new patients

Locations

1027 E Burnside St
Portland, OR 97214

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1508091521",
    "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",
            "fax_number": "503-239-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 NE COUCH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323067",
            "telephone_number": "503-239-8400",
            "fax_number": "503-239-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEB",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-19",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD 60285711",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60285711",
            "primary": true
        }
    ],
    "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 Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.