Active NPI
Raymond Benjamin Bracis, M.D.
- Infectious Disease Physician
- Portland, OR
National Provider Identifier
1609897867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 09474
- Practice address
- 2801 N Gantenbein Ave
RM 4117
Portland, OR 97227-1623 - Phone
- (503) 240-8000
- Fax
- (503) 413-2144
- NPI assigned
- Jul 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 09474 | OR | Primary |
Addresses
Primary practice location
2801 N Gantenbein Ave
RM 4117
Portland, OR 97227-1623
Mailing address
2801 N Gantenbein Ave
RM 4117
Portland, OR 97227-1623
Phone (503) 240-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017418 | Medicaid | OR |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09474 | OR | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raymond Bracis, MD | Infectious Disease | 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.
-
- Infectious Disease Physician
- Portland, OR
- NPI 1174745418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609897867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 N GANTENBEIN AVE",
"address_2": "RM 4117",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271623",
"telephone_number": "503-240-8000",
"fax_number": "503-413-2144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 N GANTENBEIN AVE",
"address_2": "RM 4117",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271623",
"telephone_number": "503-240-8000",
"fax_number": "503-413-2144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRACIS",
"first_name": "RAYMOND",
"middle_name": "BENJAMIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "OR",
"license": "09474",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "017418",
"state": "OR"
}
],
"endpoints": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.