Individual provider Active NPI

Brian Lee, M.D.

  • Radiation Oncology Physician
  • Portland, OR
National Provider Identifier
1750503132
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD186371 Issued in OR
Practice address
9205 SW Barnes Rd
Portland, OR 97225
Phone
(503) 216-2195
Fax
(503) 216-2196
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X MD00047718 WA
Radiation Oncology Physician 2085R0001X A86003 CA
Radiation Oncology Physician 2085R0001X MD186371 OR Primary

Addresses

Primary practice location

9205 SW Barnes Rd
Portland, OR 97225

Mailing address

847 NE 19TH Ave Ste 300
Portland, OR 97232-2686
Phone (503) 963-2801

Other practice location 1

4805 NE Glisan
Garden Level
Portland, OR 97213
Phone (503) 215-6029

Other identifiers 2

IdentifierTypeStateIssuer
8486532MedicaidWA
500686689MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address blee878797@oc.providencedirect.org
Direct Messaging Address blee878797@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A86003CAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tirog at Valley PLLC Radiation Oncology Past Accepting new patients

Organizations & group practices 1

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1750503132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322686",
            "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": "9205 SW BARNES RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-216-2195",
            "fax_number": "503-216-2196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4805 NE Glisan",
            "address_2": "Garden Level",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97213",
            "country_code": "US",
            "telephone_number": "503-215-6029",
            "fax_number": "503-215-6387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "BRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "MD00047718",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A86003",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OR",
            "license": "MD186371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8486532",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500686689",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "blee878797@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9205 SW Barnes Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "blee878797@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4805 NE Glisan",
            "address_2": "Garden Level",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.