Individual provider Active NPI

Charlene Wang Lai, M.D.

  • Pediatric Endocrinology Physician
  • Portland, OR
National Provider Identifier
1598177172
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
MD205699 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 418-5710
Fax
(503) 494-4953
NPI assigned
May 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD205699 OR
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Endocrinology Physician 2080P0205X MD205699 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 418-5710

Other practice location 1

700 S.W. Campus Drive
Portland, OR 97239
Phone (503) 346-0640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170901000126 PA Practitioner - Pediatric Medicine 4183841638 Reassigns benefits to 1 organization
I20210908000694 OR Practitioner - Pediatric Medicine 4183841638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Saint Louis University School of Medicine, 2014
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)

875 Oak St SE
Suite 3040
Salem, OR 97301-3975
Phone (503) 494-4808

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD205699ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Jul 12, 2017 Accepting new patients
University Professional Services CurrentSince Sep 1, 2021 Accepting new patients
City of Philadelphia Current Accepting new patients
City of Philadelphia CurrentSince Jul 12, 2017 Accepting new patients
University Professional Services CurrentSince Sep 1, 2021 Accepting new patients
Peacehealth Medical Group Pediatrics PastSince Sep 1, 2021 Accepting new patients
University Professional Services Pediatrics PastSince Sep 1, 2021 Accepting new patients

Locations

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

901 E 18th Ave
Eugene, OR 97403
Phone (541) 346-3575

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

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

875 Oak St SE
Salem, OR 97301
Phone (503) 561-5719

875 Oak St SE
Ste 3040
Salem, OR 97301
Phone (503) 494-4808

1101 Market St
Fl 10
Philadelphia, PA 19107

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

Interoperability endpoints

  • Direct secure messaging: clai82759@direct.ohsu.edu

Organizations & group practices 7

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": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1598177172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-5710",
            "fax_number": "503-494-4953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-5710",
            "fax_number": "503-494-4953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 S.W. Campus Drive",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97239",
            "country_code": "US",
            "telephone_number": "503-346-0640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAI",
        "first_name": "CHARLENE",
        "middle_name": "WANG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2024-04-30",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD205699",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "OR",
            "license": "MD205699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.