Individual provider Active NPI

Tyler J Reimann, MD

  • Family Medicine Physician
  • Beaverton, OR
National Provider Identifier
1629503966
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD210286 Issued in OR
Practice address
12345 SW Horizon Blvd Ste 57
Beaverton, OR 97007-9475
Phone
(503) 216-8820
NPI assigned
Apr 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD210286 OR Primary

Addresses

Primary practice location

12345 SW Horizon Blvd Ste 57
Beaverton, OR 97007-9475

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other practice location 1

10330 SE 32nd Ave Ste 205
Milwaukie, OR 97222-6594
Phone (503) 513-8950

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
I20220929002634 OR Practitioner - Family Practice 8921333444 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2019
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

4920 N Interstate Ave
Portland, OR 97217-3653
Phone (503) 215-3300

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD210286ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Family Medicine Current Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2023 Accepting new patients
Providence Health & Services - Oregon Family Medicine Current Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2022 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2022 Accepting new patients
Providence Health & Services - Oregon Family Medicine Past Accepting new patients

Locations

12345 SW Horizon Blvd
Ste 57
Beaverton, OR 97007
Phone (503) 216-8820

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500

5555 NE Elam Young Pkwy
Hillsboro, OR 97124
Phone (503) 216-1600

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

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

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

4920 N Interstate Ave
Portland, OR 97217
Phone (503) 215-3300

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

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

5330 NE Glisan St
Ste 100
Portland, OR 97213
Phone (503) 215-9700

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

1321 NE 99th Ave
Ste 100
Portland, OR 97220
Phone (503) 215-4050

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

Interoperability endpoints

  • Direct secure messaging: treimann785332@oc.providencedirect.org

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1629503966",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12345 SW HORIZON BLVD STE 57",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970079475",
            "telephone_number": "503-216-8820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10330 SE 32nd Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "972226594",
            "country_code": "US",
            "telephone_number": "503-513-8950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REIMANN",
        "first_name": "TYLER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD210286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.