NPIMap

Individual provider Active NPI

Brian Alec Applebaum, M.D.

  • Gastroenterology Physician
  • Oregon City, OR
National Provider Identifier
1710073200
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD27143 Issued in OR
Practice address
1508 Division St Ste 15
Oregon City, OR 97045-1583
Phone
(503) 692-3750
Fax
(503) 691-2324
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD27143 OR Primary

Addresses

Primary practice location

1508 Division St Ste 15
Oregon City, OR 97045-1583

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other practice location 1

19250 SW 90th Ave
Tualatin, OR 97062-7585
Phone (503) 692-3750

Other identifiers 2

IdentifierTypeStateIssuer
1710073200MedicaidWA
213073MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referringgso@1243.direct.myezyaccess.com The Oregon Clinic PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070223000679 OR Practitioner - Gastroenterology 0941302889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of California, Davis School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

1508 Division St
Suite 15
Oregon City, OR 97045-1583
Phone (503) 692-3750

Hospital & facility affiliations

  • Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy33
Upper gastrointestinal (GI) endoscopy for acid reflux43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD27143ORMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic PC Gastroenterology Current Accepting new patients
The Oregon Clinic, PC CurrentSince Sep 1, 2013 Accepting new patients
Oregon Clinic PC CurrentSince Sep 1, 2013 Accepting new patients
Gastroenterology Specialists of Oregon PC Gastroenterology PastSince May 20, 2008 Accepting new patients
Sedation Services Inc. PastSince Jun 4, 2012 Accepting new patients

Locations

879 N Providence Dr
Newberg, OR 97132
Phone (503) 297-3778

1508 Division St
Ste 15
Oregon City, OR 97045
Phone (503) 657-5555

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

847 NE 19th Ave
Ste 300
Portland, OR 97232

500 N Highway
Saint Helens, OR 97051
Phone (503) 229-7554

875 Oak St SE
Ste 5020
Salem, OR 97301
Phone (503) 371-4044

19250 SW 90th Ave
Tualatin, OR 97062
Phone (503) 692-3750

Interoperability endpoints

  • Direct secure messaging: bapplebaum280287@oc.providencedirect.org

Organizations & group practices 9

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 4

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1710073200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 DIVISION ST STE 15",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451583",
            "telephone_number": "503-692-3750",
            "fax_number": "503-691-2324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19250 SW 90th Ave",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970627585",
            "country_code": "US",
            "telephone_number": "503-692-3750",
            "fax_number": "503-691-2324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "APPLEBAUM",
        "first_name": "BRIAN",
        "middle_name": "ALEC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "MD27143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710073200",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213073",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referringgso@1243.direct.myezyaccess.com",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "19250 SW 90th Ave",
            "city": "Tualatin",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970627585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

Verify at the official NPI Registry.