NPIMap

Individual provider Active NPI

Jay Brad V Butler, MD

  • Orthopaedic Surgery Physician
  • Portland, OR
National Provider Identifier
1740204049
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD19035 Issued in OR
Practice address
11782 SW Barnes Rd
Ste 300
Portland, OR 97225-5914
Phone
(503) 214-5200
Fax
(503) 906-6613
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD19035 OR
Family Medicine Physician 207Q00000X MD19035 OR
Orthopaedic Surgery Physician 207X00000X MD19035 OR Primary

Addresses

Primary practice location

11782 SW Barnes Rd
Ste 300
Portland, OR 97225-5914

Mailing address

11782 SW Barnes Rd
Ste 300
Portland, OR 97225-5914
Phone (503) 214-5200

Other practice location 1

14795 SW Murray Scholls Dr Ste 109
Beaverton, OR 97007-9230
Phone (503) 906-4301

Other identifiers 2

IdentifierTypeStateIssuer
MD19035OtherORMEDICAL LICENSE
128384MedicaidOR

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
I20111109000426 OR Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 1951209857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Tulane University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11782 SW Barnes Rd
Suite 300
Portland, OR 97225-5933
Phone (503) 214-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
54.33 of 100Reported as group
Quality
57.12
Promoting interoperability
0
Improvement activities
30
Cost
86.48

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19035ORMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Fracture Clinic PC Orthopaedic Surgery CurrentSince May 2, 1994 Accepting new patients
Orthopedic & Fracture Clinic PC Specialist CurrentSince May 2, 1994 Accepting new patients

Locations

14795 SW Murray Scholls Dr
Ste 109
Beaverton, OR 97007
Phone 5039064301 ext. 4301

11782 SW Barnes Rd
Ste 300
Portland, OR 97225
Phone (503) 214-5200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1740204049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD",
            "address_2": "STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255914",
            "telephone_number": "503-214-5200",
            "fax_number": "503-906-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD",
            "address_2": "STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255914",
            "telephone_number": "503-214-5200",
            "fax_number": "503-906-6613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14795 SW Murray Scholls Dr Ste 109",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970079230",
            "country_code": "US",
            "telephone_number": "503-906-4301",
            "fax_number": "503-906-6613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JAY",
        "middle_name": "BRAD V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD19035",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD19035",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD19035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD19035",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128384",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.