NPIMap

Individual provider Active NPI

Jeffrey Stephen Olson, M.D.

  • Gastroenterology Physician
  • Clackamas, OR
National Provider Identifier
1730380791
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25234 Issued in OR
Practice address
9900 SE Sunnyside Road
Kaiser Sunnybrook Medical Office
Clackamas, OR 97015
Phone
(503) 571-9134
Fax
(503) 571-3069
NPI assigned
May 29, 2007
Last updated
Jul 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

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 25234 OR Primary

Addresses

Primary practice location

9900 SE Sunnyside Road
Kaiser Sunnybrook Medical Office
Clackamas, OR 97015

Mailing address

9900 SE Sunnyside Road
Kaiser Sunnybrook Medical Office
Clackamas, OR 97015
Phone (503) 571-9134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040806000011 OR Practitioner - GastroenterologyPractitioner - Internal Medicine 9335111822 Reassigns benefits to 1 organization
I20091230000522 WA Practitioner - Internal MedicinePractitioner - Gastroenterology 9335111822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Arizona College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Gastroenterology Clinic LLCGroup PAC ID 7315935897, 13 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 410
Portland, OR 97210-2911
Phone (503) 229-7137

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy54
Upper gastrointestinal (GI) endoscopy for acid reflux47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25234ORMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NGC Endoscopy Services LLC Current Accepting new patients
Northwest Gastroenterology Clinic LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

1130 NW 22nd Ave
Ste 410
Portland, OR 97210
Phone (503) 229-7137

Interoperability endpoints

  • Direct secure messaging: jolson1520030@direct.lhs.org

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 7

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1730380791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 SE SUNNYSIDE ROAD",
            "address_2": "KAISER SUNNYBROOK MEDICAL OFFICE",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "503-571-9134",
            "fax_number": "503-571-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 SE SUNNYSIDE ROAD",
            "address_2": "KAISER SUNNYBROOK MEDICAL OFFICE",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "503-571-9134",
            "fax_number": "503-571-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JEFFREY",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "25234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.