Individual provider Active NPI

Stephen A McLennon, MD

  • Family Medicine Physician
  • The Dalles, OR
National Provider Identifier
1760465934
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD17484 Issued in OR
Practice address
1015 Webber St Ste 100
The Dalles, OR 97058-3527
Phone
(541) 296-4804
Fax
(541) 296-3741
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD17484 OR Primary

Addresses

Primary practice location

1015 Webber St Ste 100
The Dalles, OR 97058-3527

Mailing address

1015 Webber St Ste 100
The Dalles, OR 97058-3527
Phone (541) 296-4804

Other identifiers 1

IdentifierTypeStateIssuer
033881MedicaidOR

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
I20051018000291 OR Practitioner - Family Practice 0042236267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Gilliam County Health DistrictGroup PAC ID 7517964620, 2 clinicians
Gorge NP Partners PCGroup PAC ID 7911252622, 2 clinicians

Practice addresses (Care Compare)

110 Shane St
BLDG on
Arlington, OR 97812-2070
Phone (541) 454-2888

700 Veterans Dr
The Dalles, OR 97058-9757
Phone (541) 296-4804

Merit-based Incentive Payment System (MIPS)

Final score
91.72 of 100Reported as group
Quality
73.27
Promoting interoperability
100
Improvement activities
40
Cost
90.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD17484ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gorge NP Partners PC CurrentSince May 12, 2018 Accepting new patients
North Gilliam County Health District CurrentSince Apr 10, 2024 Accepting new patients
North Gilliam County Health District CurrentSince Apr 10, 2024 Accepting new patients
Sage Adult and Geriatric Primary Care LLC PastSince Dec 12, 2021 Accepting new patients

Locations

700 Veterans Dr
The Dalles, OR 97058
Phone (541) 296-7190

1015 Webber St
Ste 100
The Dalles, OR 97058
Phone (541) 296-4804

1023 W 25th St
The Dalles, OR 97058
Phone (541) 296-4804

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1760465934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 WEBBER ST STE 100",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583527",
            "telephone_number": "541-296-4804",
            "fax_number": "541-296-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WEBBER ST STE 100",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583527",
            "telephone_number": "541-296-4804",
            "fax_number": "541-296-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLENNON",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD17484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033881",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Dalles, OR

Sources for this page

Verify at the official NPI Registry.