Individual provider Active NPI

Stephen Smith Babson

  • Family Medicine Physician
  • Tigard, OR
National Provider Identifier
1699286153
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD212713 Issued in OR
Practice address
11900 SW Greenburg Rd
Tigard, OR 97223-6453
Phone
(503) 386-5424
NPI assigned
Oct 23, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD212713 OR Primary

Addresses

Primary practice location

11900 SW Greenburg Rd
Tigard, OR 97223-6453

Mailing address

12055 SW Breyman Ave
Portland, OR 97219-8414

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8220

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
I20221213000379 OR Practitioner - Family Practice 7214337419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Cynthia Gulick PCGroup PAC ID 2860487279, 23 clinicians

Practice addresses (Care Compare)

11900 SW Greenburg Rd
Tigard, OR 97223-6453
Phone (503) 620-5556

Hospital & facility affiliations

  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD212713ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cynthia Gulick, PC Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
My Other Me PastSince Oct 30, 2022 Accepting new patients

Locations

11900 SW Greenburg Rd
Tigard, OR 97223
Phone (503) 386-5424

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 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": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1699286153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12055 SW BREYMAN AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972198414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 SW GREENBURG RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236453",
            "telephone_number": "503-386-5424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-8220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BABSON",
        "first_name": "STEPHEN",
        "middle_name": "SMITH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-23",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD212713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.