Individual provider Active NPI

Avishai Meyer, MD

  • Surgery Physician
  • Portland, OR
National Provider Identifier
1750437364
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
TEP 6124 Issued in NE
Practice address
1040 NW 22ND Ave
Ste 500
Portland, OR 97210-3057
Phone
(503) 227-5050
Fax
(503) 227-2462
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X TEP 6124 NE Primary

Addresses

Primary practice location

1040 NW 22ND Ave
Ste 500
Portland, OR 97210-3057

Mailing address

1040 NW 22ND Ave
Ste 500
Portland, OR 97210-3057
Phone (503) 227-5050

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ameyer669368@oc.providencedirect.org

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
I20160610001605 OR Practitioner - General Surgery 5294982559 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians
Legacy Good Samaritan Hospital and Medical CenterGroup PAC ID 0547179939, 190 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711

1015 Nw22Nd Ave
Suite 34
Portland, OR 97210-3025
Phone (503) 413-6376

1040 NW 22ND Ave
Portland, OR 97210-3097

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074

Hospital & facility affiliations

  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Columbia Memorial Hospital Hospital, Astoria, OR, CCN 381320
  • Adventist Health Tillamook Hospital, Tillamook, OR, CCN 381317

Merit-based Incentive Payment System (MIPS)

Final score
92.34 of 100Reported as group
Quality
92.55
Promoting interoperability
100
Improvement activities
40
Cost
76.53

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEP 6124NEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 1, 2021 Accepting new patients
Legacy Clinics LLC CurrentSince Jan 9, 2025 Accepting new patients
Emma J Patterson MD PC Surgery CurrentSince Jul 9, 2025 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Aug 3, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 1, 2021 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Aug 3, 2020 Accepting new patients
Legacy Clinics LLC CurrentSince Jan 9, 2025 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Past Accepting new patients

Locations

25050 SE Stark St
Ste 265
Gresham, OR 97030
Phone (503) 413-2005

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1040 NW 22nd Ave
Ste 520
Portland, OR 97210
Phone (503) 413-7557

1130 NW 22nd Ave
Ste 500
Portland, OR 97210
Phone (503) 229-7339

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

825 NE 20th Ave
Ste 340
Portland, OR 97232
Phone (503) 227-5050

1040 NW 22nd Ave
Ste 500
Portland, OR 97210
Phone (503) 227-5050

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

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

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

Interoperability endpoints

  • Direct secure messaging: ameyer142989@direct.lhs.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 11

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1750437364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE",
            "address_2": "STE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103057",
            "telephone_number": "503-227-5050",
            "fax_number": "503-227-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE",
            "address_2": "STE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103057",
            "telephone_number": "503-227-5050",
            "fax_number": "503-227-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "AVISHAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "TEP 6124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ameyer669368@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "727 S Wahanna Rd",
            "city": "Seaside",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971387735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.