Individual provider Active NPI

Sophia Bornstein, M.D. PH.D.

  • Radiation Oncology Physician
  • Portland, OR
National Provider Identifier
1639498561
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD173196 Issued in OR
Practice address
9205 SW Barnes Rd
Suite 20
Portland, OR 97225-6603
Phone
(503) 216-2401
Fax
(503) 216-4041
NPI assigned
May 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X PG151647 OR
Radiation Oncology Physician 2085R0001X MD173196 OR Primary

Addresses

Primary practice location

9205 SW Barnes Rd
Suite 20
Portland, OR 97225-6603

Mailing address

3181Swsam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8756

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
I20150826002712 OR Practitioner - Radiation Oncology 3577718295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Oregon Health Sciences University School of Medicine, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1400 SW 5TH Ave
FL 5
Portland, OR 97201-5509

1700 E 19TH St
The Dalles, OR 97058-3317

173 Blue Heron CT
The Dalles, OR 97058-3813

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PG151647ORMDInternal Medicine Physician
MD173196ORMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services Current Accepting new patients
Mid-Columbia Medical Center CurrentSince Jul 1, 2019 Accepting new patients
Healthcare for the Mid-Columbia Region Current Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

Interoperability endpoints

  • Direct secure messaging: sbornstein117161@direct.ohsu.edu

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 1

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": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1639498561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181SWSAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD",
            "address_2": "SUITE 20",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256603",
            "telephone_number": "503-216-2401",
            "fax_number": "503-216-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNSTEIN",
        "first_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "M.D. PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "PG151647",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OR",
            "license": "MD173196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.