Individual provider Active NPI

Vitalie Dionis Lupu, MD

  • Neurology Physician
  • Portland, OR
National Provider Identifier
1609837913
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD26492 Issued in OR
Practice address
9155 SW Barnes Rd
Suite 317
Portland, OR 97225-6625
Phone
(503) 216-1150
NPI assigned
Mar 29, 2006
Last updated
Mar 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD26492 OR Primary
Clinical Neurophysiology Physician 2084N0600X MD26492 OR

Addresses

Primary practice location

9155 SW Barnes Rd
Suite 317
Portland, OR 97225-6625

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 216-1150

Other identifiers 1

IdentifierTypeStateIssuer
240081MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vlupu134126@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
I20070123000341 OR Practitioner - NeurologyPractitioner - Nephrology 5092716753 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

9135 SW Barnes Rd
Portland, OR 97225-6643

9205 SW Barnes Rd
Portland, OR 97225-6603

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 CurrentSince Feb 12, 2016 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Feb 12, 2016 Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 12, 2016 Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 1, 2016 Accepting new patients
Providence Health & Services - Oregon CurrentSince Feb 12, 2016 Accepting new patients
Legacy Clinics LLC CurrentSince Nov 25, 2019 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

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

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

9155 SW Barnes Rd
Ste 317
Portland, OR 97225
Phone (503) 216-1150

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Organizations & group practices 8

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 5

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1609837913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-216-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD",
            "address_2": "SUITE 317",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256625",
            "telephone_number": "503-216-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPU",
        "first_name": "VITALIE",
        "middle_name": "DIONIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD26492",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "OR",
            "license": "MD26492",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240081",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vlupu134126@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9155 SW Barnes Rd",
            "address_2": "SUITE 317",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.