Active NPI
Steven Ryan Demeester, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Portland, OR
National Provider Identifier
1609807973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- MD174787
- Practice address
- 4805 NE Glisan St
Suite 6N60
Portland, OR 97213-2933 - Phone
- (503) 281-0561
- Fax
- (503) 416-7377
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | G82268 | CA | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | G82268 | CA | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | MD174787 | OR | Primary |
Addresses
Primary practice location
4805 NE Glisan St
Suite 6N60
Portland, OR 97213-2933
Mailing address
847 NE 19TH Ave
Suite 300
Portland, OR 97232-2684
Phone (503) 963-2801
Other practice location 1
9155 SW Barnes Rd Ste 735
Portland, OR 97225-6634
Phone (503) 281-0561
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020039943 | Other | CA | MEDICARE RAILROAD |
| 2049670 | Medicaid | WA | |
| 00G822680 | Medicaid | CA | |
| 00G822680C29 | Other | CA | CAL OPTIMA PIN |
| 500696092 | Medicaid | OR | |
| 00G822680 | Other | CA | BLUE SHIELD PIN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | referringgmis@orclinic.direct-ci.net | The Oregon Clinic PC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 82268 | CA | MD | Pharmacist |
| G82268 | CA | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Usc Surgeons, Inc. | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Surgery Physician
- Los Angeles, CA
- NPI 1821034315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636588800000",
"number": "1609807973",
"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": "4805 NE GLISAN ST",
"address_2": "SUITE 6N60",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132933",
"telephone_number": "503-281-0561",
"fax_number": "503-416-7377"
}
],
"practiceLocations": [
{
"address_1": "9155 SW Barnes Rd Ste 735",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972256634",
"country_code": "US",
"telephone_number": "503-281-0561",
"fax_number": "503-416-7377",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEMEESTER",
"first_name": "STEVEN",
"middle_name": "RYAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2021-11-11",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G82268",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "CA",
"license": "G82268",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "OR",
"license": "MD174787",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "020039943",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2049670",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G822680",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAL OPTIMA PIN",
"identifier": "00G822680C29",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500696092",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PIN",
"identifier": "00G822680",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "referringgmis@orclinic.direct-ci.net",
"affiliation": "Y",
"affiliationName": "The Oregon Clinic PC",
"address_1": "4805 NE Glisan St",
"address_2": "Suite 6N60",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972132933",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.