Individual provider Active NPI

Maria C. Leiva, M.D.

  • Obstetrics & Gynecology Physician
  • Portland, OR
National Provider Identifier
1790766244
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD 25402 Issued in OR
Practice address
9555 SW Barnes Rd
Suite 100
Portland, OR 97225-6663
Phone
(503) 292-3577
Fax
(503) 691-3615
NPI assigned
Nov 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD 25402 OR Primary

Addresses

Primary practice location

9555 SW Barnes Rd
Suite 100
Portland, OR 97225-6663

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone (503) 418-4500

Other identifiers 1

IdentifierTypeStateIssuer
022879MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mleiva184952@oc.providencedirect.org

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
I20041208001201 OR Practitioner - Obstetrics/Gynecology 4284690447 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 25402ORMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince May 4, 2013 Accepting new patients
Tuality Medical Group LLC CurrentSince Dec 1, 2020 Accepting new patients
Providence Health & Services - Oregon Obstetrics & Gynecology CurrentSince Apr 19, 2010 Accepting new patients
Providence Health & Services - Oregon CurrentSince May 4, 2013 Accepting new patients
University Professional Services CurrentSince Dec 1, 2020 Accepting new patients
Tuality Medical Group LLC CurrentSince Dec 1, 2020 Accepting new patients
Providence Health & Services - Oregon Obstetrics & Gynecology Current Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 19, 2010 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2017 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Dec 1, 2020 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Northwest Urology, LLC Past Accepting new patients
Jefferson University Physicians Obstetrics & Gynecology Past Accepting new patients
Women'S Healthcare Associates, LLC PastSince Jul 31, 1999 Accepting new patients

Locations

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

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

9135 SW Barnes Rd
Ste 761
Portland, OR 97225
Phone (503) 216-2602

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

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

545 NE 47th Ave
Ste 102
Portland, OR 97213
Phone (503) 215-6262

Interoperability endpoints

  • Direct secure messaging: mleiva125361@direct.ohsu.edu

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1790766244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-418-4500",
            "fax_number": "503-494-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256663",
            "telephone_number": "503-292-3577",
            "fax_number": "503-691-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIVA",
        "first_name": "MARIA",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2021-03-19",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD 25402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022879",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mleiva184952@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "545 NE 47th Ave Ste 102",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.