Logan W Guckien, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD200586 Issued in OR

Practice address

5050 NE Hoyt St Ste 454
Portland, OR 97213-2984

Phone

(503) 215-6405

NPI assigned

Jun 1, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Family Practice

Education

Indiana University School of Medicine, 2017

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Home Health Home health agency, Portland, OR, CCN 387048
• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lguckien1372105@oc.providencedirect.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.

• Providence Health & Services Oregon

  dba Providence Medical Group

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  NPD

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

• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation
• Providence Health & Services Oregon

  dba Providence Home Health

  • Home Health Agency
  • Portland, OR
  • NPI 1790873461
  Care Compare affiliation

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1649708710",
    "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",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST STE 454",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132984",
            "telephone_number": "503-215-6405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 N Senate Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462022213",
            "country_code": "US",
            "telephone_number": "317-962-0857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUCKIEN",
        "first_name": "LOGAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-01",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD200586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lguckien1372105@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 454",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paul Edward Guastadisegni, PH.D.
• Rebecca Guberman, LMT,CNT
• Kelly Dean Gubler, D.O.
• Ankita Guchait, QMHA
• James Guckenberger
• Narine Gudar
• Jonathan T. Gudman, MD
• Julie Gudmestad, P.T.
• Diane S Gudmundsen, D.C.
• Christine Guenin

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.
• 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.