Individual provider Active NPI

Renee Marie Carisio Farber, MD

  • Obstetrics & Gynecology Physician
  • Portland, OR
National Provider Identifier
1700855517
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD169393 Issued in OR
Practice address
4805 NE Glisan St
Unit 3K
Portland, OR 97213-2933
Phone
(503) 215-6150
NPI assigned
Mar 15, 2006
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0101232018 VA
Obstetrics & Gynecology Physician 207V00000X MD169393 OR Primary

Addresses

Primary practice location

4805 NE Glisan St
Unit 3K
Portland, OR 97213-2933

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other identifiers 1

IdentifierTypeStateIssuer
500678128MedicaidOR

Electronic endpoints 7

TypeEndpointUseAffiliation
Direct Messaging Address rcarisiofarber476193@oc.providencedirect.org
Direct Messaging Address rcarisiofarber476193@oc.providencedirect.org
Direct Messaging Address rcarisiofarber476193@oc.providencedirect.org
Direct Messaging Address rcarisiofarber476193@oc.providencedirect.org
Direct Messaging Address rcarisiofarber476193@oc.providencedirect.org
Direct Messaging Address rcarisiofarber476193@oc.providencedirect.org
Direct Messaging Address rcarisiofarber476193@oc.providencedirect.org

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
I20141105001124 OR Practitioner - Obstetrics/Gynecology 2264525666 Reassigns benefits to 1 organization
I20210412002141 WA Practitioner - Obstetrics/Gynecology 2264525666 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101232018VAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Obstetrics & Gynecology CurrentSince Jan 1, 2015 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
University Professional Services Current Accepting new patients
Multicare Health System CurrentSince Feb 1, 2021 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2015 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Feb 1, 2021 Accepting new patients
Central Virginia OB-GYN Group, PC Obstetrics & Gynecology Past Accepting new patients
Renee Carisio-Farber, MD PastSince Aug 1, 2002 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

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

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

4805 NE Glisan St
Unit 3K
Portland, OR 97213
Phone (503) 215-6150

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Interoperability endpoints

  • Direct secure messaging: rcarisiofarber125541@direct.ohsu.edu
  • Direct secure messaging: rcarisiofarber567905@direct.multicare.org

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1700855517",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "address_2": "UNIT 3K",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARISIO FARBER",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101232018",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD169393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500678128",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarisiofarber476193@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "10330 SE 32nd Ave Ste 305",
            "city": "Milwaukie",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972226596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarisiofarber476193@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4805 NE Glisan St",
            "address_2": "UNIT 3K",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarisiofarber476193@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1125 MAY ST",
            "address_2": "Suite 202",
            "city": "Hood River",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarisiofarber476193@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "545 NE 47th Ave Ste 102",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132237",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarisiofarber476193@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4805 NE Glisan St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarisiofarber476193@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "725 S Wahanna Rd",
            "city": "Seaside",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971387735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarisiofarber476193@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "810 12th St",
            "city": "Hood River",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970311587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.