Elizabeth Jane Harbottle, M.B., B.CH., B.A.O

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD180821 Issued in OR

Practice address

1015 NW 22ND Ave
Graduate Medical Education
Portland, OR 97210-3025

Phone

(503) 413-7590

NPI assigned

Jul 31, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
• Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

Merit-based Incentive Payment System (MIPS)

Final score

94.62 of 100Reported as apm

Quality

77.21

Promoting interoperability

99.06

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eharbottle86632@direct.lhs.org

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Silverton Health

  • General Acute Care Hospital
  • Silverton, OR
  • NPI 1669424354
  Medicare reassignment NPD
• Legacy Clinics LLC

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  NPD
• Silverton Health

  • Clinic/Center
  • Woodburn, OR
  • NPI 1215347109
  NPD
• Silverton Health

  • Clinic/Center
  • Molalla, OR
  • NPI 1861116055
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003367491
  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1295756898

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108

  Hospital

  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216
  Care Compare affiliation

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1639501737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 NW 22ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103025",
            "telephone_number": "503-413-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 NW 22ND AVE",
            "address_2": "GRADUATE MEDICAL EDUCATION",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103025",
            "telephone_number": "503-413-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBOTTLE",
        "first_name": "ELIZABETH",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "M.B., B.CH., B.A.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD180821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Bjorn Harboldt, M.D.
• Harbor Care Corporation
• Harbor Health Clinic
• Harbor of Hope LLC
• Harborstone Behavioral Residence LLC
• Stephen Paul Harbour, DMD
• Thomas David Harburg, M.D.
• Kip Marilyn Hard, DC, L.AC
• Jontae Malik Hardaway
• Michelle Marie Hardaway, MSW

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.