Stephen B Bader, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

MD17045 Issued in OR

Practice address

4805 NE Glisan St
Garden Level
Portland, OR 97213-2933

Phone

(503) 215-6029

Fax

(503) 215-6387

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1790787422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "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": "4805 NE GLISAN ST",
            "address_2": "GARDEN LEVEL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-6029",
            "fax_number": "503-215-6387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9280 SE Sunnybrook Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970159315",
            "country_code": "US",
            "telephone_number": "503-513-3300",
            "fax_number": "503-513-3310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BADER",
        "first_name": "STEPHEN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2023-12-05",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OR",
            "license": "MD17045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029657",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8128688",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Bianca Bade
• Matthew Walsh Bade
• Amy Noel Bader, N.D.
• Diane Janelle Bader, LCSW
• Mohammad A Bader, L.PC
• Jacob Andrew Badger
• James Allen Badgley
• Ann Marie Badgwell
• Gina Badilla, QMHA-R
• Yara Christina Hadi Badrakhan

• Radiation Oncology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Radiation Oncology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.