Individual provider Active NPI

Jeremiah Jack Reasoner, MD

  • Anesthesiology Physician
  • Portland, OR
National Provider Identifier
1679077937
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD207403 Issued in OR
Practice address
707 SW Washington St Ste 700
Portland, OR 97205-3523
Phone
(503) 299-9906
Fax
(503) 225-9002
NPI assigned
Mar 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X MD207403 OR Primary

Addresses

Primary practice location

707 SW Washington St Ste 700
Portland, OR 97205-3523

Mailing address

PO Box 35147
#1801
Seattle, WA 98124-5147

Other practice location 1

2401 S 31st St # MS 20D304
Temple, TX 76508-0001
Phone (254) 724-5306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220720001259 OR Practitioner - Anesthesiology 5991052151 Reassigns benefits to 1 organization
I20231205003391 WA Practitioner - Anesthesiology 5991052151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Oklahoma College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Anesthesiology Group PCGroup PAC ID 3476451659, 239 clinicians

Practice addresses (Care Compare)

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone (360) 487-1000

707 SW Washington St
Suite 700
Portland, OR 97205-3523
Phone (503) 299-9906

Hospital & facility affiliations

  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD207403ORMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Anesthesiology Group PC Anesthesiology CurrentSince Aug 15, 2022 Accepting new patients
Oag Trauma Services LLC Anesthesiology PastSince Jun 12, 2022 Accepting new patients

Locations

707 SW Washington St
Ste 700
Portland, OR 97205

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 2

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 2

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1679077937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35147",
            "address_2": "#1801",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SW WASHINGTON ST STE 700",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053523",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St # MS 20D304",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-5306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REASONER",
        "first_name": "JEREMIAH",
        "middle_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2022-06-08",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD207403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.