Individual provider Active NPI

Stephen D Sethi, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1538108246
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD25949 Issued in OR
Practice address
4805 NE Glisan St
Suite BG05
Portland, OR 97213-2933
Phone
(503) 215-2392
Fax
(503) 215-6918
NPI assigned
Jun 6, 2006
Last updated
Oct 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD25949 OR Primary

Addresses

Primary practice location

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

Mailing address

PO Box 3178
Portland, OR 97208-3178
Phone (503) 215-6494

Other identifiers 1

IdentifierTypeStateIssuer
213609MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssethi117782@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
I20050907000785 OR Practitioner - HospitalistPractitioner - Internal Medicine 7911939251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

9205 SW Barnes Rd
FL 1
Portland, OR 97225-6603
Phone (503) 216-2906

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2015 Accepting new patients
Providence Health & Services - Oregon Internal Medicine Past Accepting new patients

Locations

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

1000 N Providence Dr
Ste 210
Newberg, OR 97132

1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

4400 NE Halsey St
#2
Portland, OR 97213
Phone (503) 893-6472

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

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

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

9205 SW Barnes Rd
Fl 1
Portland, OR 97225
Phone (503) 216-0790

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1538108246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3178",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083178",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "address_2": "SUITE BG05",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-2392",
            "fax_number": "503-215-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETHI",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD25949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213609",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssethi117782@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1000 N Providence Dr Ste 210",
            "city": "Newberg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971327582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.