Jessica Duan Lubahn, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD161491 Issued in OR

Practice address

10000 SE Main St
Suite 342
Portland, OR 97216-2448

Phone

(503) 255-5244

Fax

(503) 255-5120

NPI assigned

Jun 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Portland, OR
  • NPI 1740732650
  NPD
• Providence Health & Services Oregon

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Portland, OR
  • NPI 1396818993
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1619137692",
    "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": "10000 SE MAIN ST",
            "address_2": "SUITE 342",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162448",
            "telephone_number": "503-255-5244",
            "fax_number": "503-255-5120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19250 SW 65th Ave Ste 235",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970627745",
            "country_code": "US",
            "telephone_number": "503-692-4820",
            "fax_number": "503-612-0793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1130 NW 22nd Ave Ste 535",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972102976",
            "country_code": "US",
            "telephone_number": "503-274-4999",
            "fax_number": "503-796-9884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUBAHN",
        "first_name": "JESSICA",
        "middle_name": "DUAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD161491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500657210",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2044440",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referringaua@orclinic.direct-ci.net",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "19250 SW 65th Ave Ste 235",
            "city": "Tualatin",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970627745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Zhengchun Lu, MD, PHD
• Zouyan Lu, M.D.
• Luahna Ude, PHD, PC
• Bowen Luan, PT
• Jingyi Luan
• Jordon G Lubahn, M.D.
• Aaron M Lubarsky-Ford
• Rebekah Lubeck
• Loren Elizabeth Lubin, ND, LAC
• Maya Lubin, LPCA

• Urology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Urology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.