Active NPI
Brian Lee, M.D.
- Radiation Oncology Physician
- Portland, OR
National Provider Identifier
1750503132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- MD186371
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8486532 | Medicaid | WA | |
| 500686689 | Medicaid | OR |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| A86003 | CA | MD | Radiation Oncology Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Radiation Oncology Physician
- Renton, WA
- NPI 1568485761
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.