Individual provider Active NPI

Bruce Alan Marks, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1669488151
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200350074NP Issued in OR
Practice address
3930 SE Division St
Portland, OR 97202-1643
Phone
(503) 418-3900
NPI assigned
Aug 1, 2006
Last updated
Jul 13, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200141561RN OR
Family Nurse Practitioner 363LF0000X 200350074NP OR Primary

Addresses

Primary practice location

3930 SE Division St
Portland, OR 97202-1643

Mailing address

3930 SE Division St
Portland, OR 97202-1643
Phone (503) 418-3900

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
I20040427000722 OR Practitioner - Nurse Practitioner 9335136969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3930 SE Division St
Portland, OR 97202-1643
Phone (503) 418-3900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200350074NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Health & Science University Current Accepting new patients
Oregon Health & Science University CurrentSince Oct 1, 2004 Accepting new patients
Oregon Health & Science University CurrentSince Oct 1, 2004 Accepting new patients

Locations

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

2241 Lloyd Ctr
Portland, OR 97232

3930 SE Division St
Portland, OR 97202
Phone (503) 418-3900

51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222

Interoperability endpoints

  • Direct secure messaging: bmarks14162@direct.ohsu.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1669488151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021643",
            "telephone_number": "503-418-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021643",
            "telephone_number": "503-418-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "BRUCE",
        "middle_name": "ALAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200141561RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200350074NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.