Individual provider Active NPI

Edward Alexander Dyer, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Portland, OR
National Provider Identifier
1760601694
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
MD28675 Issued in OR
Practice address
1130 NW 22ND Ave Ste 220
Portland, OR 97210-2969
Phone
(503) 413-8988
Fax
(503) 413-5629
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X LL15488 OR
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD28675 OR Primary

Addresses

Primary practice location

1130 NW 22ND Ave Ste 220
Portland, OR 97210-2969

Mailing address

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

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA, IL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20140723001298 OR Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 1254586753 Reassigns benefits to 2 organizations
I20211118000806 WA Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 1254586753 Reassigns benefits to 2 organizations
I20231220003145 IL Practitioner - Critical Care (Intensivists) 1254586753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200

Hospital & facility affiliations

  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL15488ORMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Critical Care Physicians of Illinois LLC Critical Care Medicine CurrentSince Oct 29, 2023 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Oct 5, 2021 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Dec 7, 2021 Accepting new patients
Legacy Clinics LLC Critical Care Medicine CurrentSince Mar 7, 2017 Accepting new patients
The Vancouver Clinic Inc PS Critical Care Medicine Current Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Dec 7, 2021 Accepting new patients
Sound Physicians Intensivists of Washington PLLC Critical Care Medicine CurrentSince Sep 23, 2023 Accepting new patients
Legacy Salmon Creek Hospital Hospitalist CurrentSince Oct 5, 2021 Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

1325 N Highland Ave
Aurora, IL 60506
Phone (630) 801-2756

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

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

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

1460 G St
Springfield, OR 97477
Phone (541) 431-0665

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

700 NE 87th Ave
Ste 360
Vancouver, WA 98664
Phone (360) 896-7070

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

Organizations & group practices 8

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 1

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1760601694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE STE 220",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102969",
            "telephone_number": "503-413-8988",
            "fax_number": "503-413-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE STE 220",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102969",
            "telephone_number": "503-413-8988",
            "fax_number": "503-413-5629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYER",
        "first_name": "EDWARD",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "LL15488",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "MD28675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.