NPIMap

Individual provider Active NPI

Samuel Christofer Crane, MD

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1801031588
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD1508620 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 597-3130
NPI assigned
Dec 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD1508620 OR Primary

Addresses

Primary practice location

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

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 597-3130

Other identifiers 1

IdentifierTypeStateIssuer
1801031588MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110408000624 OR Practitioner - Family Practice 0345424743 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10570 SW 161St CT
Beaverton, OR 97007-8171

2055 NW Savier St
Suite 201
Portland, OR 97209-1773

2500 NE Neff Rd
Bend, OR 97701-6015

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD1508620ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tuality Healthcare Family Medicine Current Accepting new patients
Oregon Health & Science University Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Mar 20, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Mar 20, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine Current Accepting new patients
Oregon Health & Science University CurrentSince Jan 6, 2017 Accepting new patients
Oregon Health & Science University CurrentSince Jan 6, 2017 Accepting new patients
University Professional Services Current Accepting new patients
Tuality Medical Group LLC CurrentSince Dec 1, 2024 Accepting new patients
Tuality Healthcare CurrentSince Nov 20, 2017 Accepting new patients
Tuality Healthcare Current Accepting new patients

Locations

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

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

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

3930 SE Division St
Portland, OR 97202
Phone (503) 418-3900

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

546 NE 12th Ave
Rm 126
Portland, OR 97232
Phone (503) 494-3900

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222

Interoperability endpoints

  • Direct secure messaging: scranemd6696@direct.ohsu.edu

Organizations & group practices 11

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 12

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": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1801031588",
    "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": "972393011",
            "telephone_number": "503-597-3130",
            "fax_number": "509-488-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-597-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANE",
        "first_name": "SAMUEL",
        "middle_name": "CHRISTOFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-09",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD1508620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801031588",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.