NPIMap

Individual provider Active NPI

Robert Adams Dubose, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Portland, OR
National Provider Identifier
1578610374
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD27662 Issued in OR
Practice address
2222 NW Lovejoy St
Suite 315
Portland, OR 97210-3033
Phone
(503) 226-6321
Fax
(503) 227-3422
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD27662 OR Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD00048374 WA

Addresses

Primary practice location

2222 NW Lovejoy St
Suite 315
Portland, OR 97210-3033

Mailing address

847 NE 19TH Ave
Suite 300
Portland, OR 97232-2684
Phone (503) 963-2801

Other identifiers 2

IdentifierTypeStateIssuer
8488389MedicaidWA
006233MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070831000104 OR Practitioner - Thoracic Surgery 1658464029 Reassigns benefits to 1 organization
I20080130000606 WA Practitioner - Thoracic SurgeryPractitioner - General Surgery 1658464029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: General Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

505 NE 87TH Ave
Vancouver, WA 98664-1965

8821 NE 5TH St
Vancouver, WA 98664-3200
Phone (360) 514-1900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)33

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince May 1, 2015 Accepting new patients
University Professional Services Current Accepting new patients
Peacehealth Past Accepting new patients
University Professional Services PastSince May 1, 2015 Accepting new patients
The Oregon Clinic PC Past Accepting new patients

Locations

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

875 Oak St SE
Ste 5020
Salem, OR 97301
Phone (503) 371-4044

1615 Delaware St
Ste 30
Longview, WA 98632
Phone (360) 501-3555

312 SE Stonemill Dr
Ste 150
Vancouver, WA 98684
Phone (360) 254-2323

Interoperability endpoints

  • Direct secure messaging: rdubosemd92228@direct.ohsu.edu

Organizations & group practices 6

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 3

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1578610374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322684",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST",
            "address_2": "SUITE 315",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103033",
            "telephone_number": "503-226-6321",
            "fax_number": "503-227-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "ROBERT",
        "middle_name": "ADAMS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OR",
            "license": "MD27662",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD00048374",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8488389",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006233",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.