Individual provider Active NPI

Ann Marie Paulsen, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1780848499
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD153258 Issued in OR
Practice address
6640 SW Redwood LN
Portland
Portland, OR 97224-7187
Phone
(503) 620-7358
Fax
(503) 624-6144
NPI assigned
Jul 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD153258 OR Primary

Addresses

Primary practice location

6640 SW Redwood LN
Portland
Portland, OR 97224-7187

Mailing address

800 SW 13TH Ave
Portland, OR 97205-1902
Phone (503) 221-0161

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amccartney1715@direct.theportlandclinic.net

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
I20110811000889 OR Practitioner - Internal Medicine 9830368620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Nebraska College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland ClinicGroup PAC ID 8224942867, 93 clinicians

Practice addresses (Care Compare)

6640 SW Redwood LN
Portland, OR 97224-7187
Phone (603) 620-7358

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD153258ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Portland Clinic Laboratory Current Accepting new patients
Portland Clinic Internal Medicine CurrentSince Aug 18, 2011 Accepting new patients

Locations

15950 SW Millikan Way
Beaverton, OR 97003
Phone (503) 646-0161

5005 NE Sandy Blvd
Portland, OR 97213
Phone (503) 233-6940

6640 SW Redwood Ln
Portland, OR 97224
Phone (503) 620-7358

800 SW 13th Ave
Portland, OR 97205
Phone (503) 221-0161

9250 SW Hall Blvd
Tigard, OR 97223
Phone (503) 221-0161

Interoperability endpoints

  • Direct secure messaging: apaulsen31779@theportlandclinic.gardenplot.direct-ci.com
  • Direct secure messaging: amccartney1715@direct.theportlandclinic.net

Organizations & group practices 2

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 2

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": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1780848499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051902",
            "telephone_number": "503-221-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 SW REDWOOD LN",
            "address_2": "PORTLAND",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247187",
            "telephone_number": "503-620-7358",
            "fax_number": "503-624-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSEN",
        "first_name": "ANN MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD153258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amccartney1715@direct.theportlandclinic.net",
            "affiliation": "N",
            "address_1": "6640 SW Redwood Ln",
            "address_2": "Portland",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972247187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.