Individual provider Active NPI

Bradley Zwahlen

  • Family Nurse Practitioner
  • Oregon City, OR
National Provider Identifier
1629581558
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202000931NP-PP Issued in OR
Practice address
1508 Division St Ste 15
Oregon City, OR 97045-1583
Phone
(503) 692-3750
Fax
(503) 691-2324
NPI assigned
Nov 14, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 202000931NP-PP OR Primary

Addresses

Primary practice location

1508 Division St Ste 15
Oregon City, OR 97045-1583

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other practice location 1

19250 SW 90th Ave
Tualatin, OR 97062-7585
Phone (503) 692-3750

Other identifiers 1

IdentifierTypeStateIssuer
500780745MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referringgso@1243.direct.myezyaccess.com The Oregon Clinic PC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200706002695 OR Practitioner - Nurse Practitioner 6800219163 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

1508 Division St
Suite 15
Oregon City, OR 97045-1583
Phone (503) 692-3750

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
202000931NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic PC Current Accepting new patients
Oregon Clinic PC CurrentSince Nov 27, 2023 Accepting new patients
The Oregon Clinic, PC CurrentSince Nov 27, 2023 Accepting new patients
Legacy Clinics LLC CurrentSince Jul 24, 2021 Accepting new patients

Locations

879 N Providence Dr
Newberg, OR 97132
Phone (503) 297-3778

1508 Division St
Ste 15
Oregon City, OR 97045
Phone (503) 657-5555

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

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

2222 NW Lovejoy St
Ste 512
Portland, OR 97210
Phone (503) 222-0262

2222 NW Lovejoy St
Portland, OR 97210
Phone (503) 222-3638

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

500 N Highway
Saint Helens, OR 97051
Phone (503) 229-7554

19250 SW 90th Ave
Tualatin, OR 97062
Phone (503) 692-3750

Interoperability endpoints

  • Direct secure messaging: bzwahlen515870@oc.providencedirect.org

Organizations & group practices 4

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 3

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": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1629581558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 DIVISION ST STE 15",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451583",
            "telephone_number": "503-692-3750",
            "fax_number": "503-691-2324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19250 SW 90th Ave",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970627585",
            "country_code": "US",
            "telephone_number": "503-692-3750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZWAHLEN",
        "first_name": "BRADLEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-14",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202000931NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500780745",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referringgso@1243.direct.myezyaccess.com",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "1508 Division St Ste 15",
            "city": "Oregon City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970451583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

Verify at the official NPI Registry.