Individual provider Active NPI

Marian Elizabeth Smith, DO

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1790791374
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO25261 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Cr110
Portland, OR 97239-3011
Phone
(503) 494-8051
Fax
(503) 494-1310
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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 DO25261 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Cr110
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Cr110
Portland, OR 97239-3011
Phone (503) 494-8051

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
I20050614000046 OR Practitioner - Internal Medicine 3375587116 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Emanuel Hospital and Health CenterGroup PAC ID 4587573639, 235 clinicians
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

300 N Graham St
Suite 300
Portland, OR 97227-1666
Phone (503) 413-3030

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Hospital & facility affiliations

  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Oct 2, 2017 Accepting new patients
University Professional Services CurrentSince Jan 1, 2009 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Oct 2, 2017 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Oct 2, 2017 Accepting new patients
University Professional Services CurrentSince Jan 1, 2009 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Oct 2, 2017 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
University Professional Services Past Accepting new patients

Locations

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

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

300 N Graham St
Ste 200
Portland, OR 97227
Phone (503) 413-4134

300 N Graham St
Ste 300
Portland, OR 97227
Phone (503) 280-3620

3181 SW Sam Jackson Park Rd
#110
Portland, OR 97239
Phone (503) 418-1593

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

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

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

500 N Columbia River Hwy
Ste 6
Saint Helens, OR 97051
Phone (503) 366-5101

Interoperability endpoints

  • Direct secure messaging: msmith15435@direct.lhs.org
  • Direct secure messaging: msmithdo19944@direct.ohsu.edu

Organizations & group practices 9

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 8

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1790791374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "CR110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8051",
            "fax_number": "503-494-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "CR110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8051",
            "fax_number": "503-494-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARIAN",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO25261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.