Individual provider Active NPI

Benjamin Russell Smith, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Portland, OR
National Provider Identifier
1801184601
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
185564 Issued in OR
Practice address
1312 SW Washington St
Portland, OR 97205-2327
Phone
(650) 937-9774
NPI assigned
Jul 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 185564 OR Primary

Addresses

Primary practice location

1312 SW Washington St
Portland, OR 97205-2327

Mailing address

1312 SW Washington St
Portland, OR 97205-2327
Phone (650) 937-9774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130826000284 CA Practitioner - Family Practice 6204079130 Reassigns benefits to 1 organization
I20190111000439 OR Practitioner - Family Practice 6204079130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Harvard Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multnomah CountyGroup PAC ID 6608771787, 111 clinicians

Practice addresses (Care Compare)

12710 SE Division
Portland, OR 97236-3134
Phone (503) 988-3601

600 NE 8TH St
Gresham, OR 97030-7317
Phone (503) 988-7468

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
185564ORMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Jul 21, 2023 Accepting new patients
Multnomah County CurrentSince Oct 9, 2018 Accepting new patients
Signify Health Medical Associates of California, PC CurrentSince Jul 24, 2023 Accepting new patients
Multnomah County CurrentSince Oct 9, 2018 Accepting new patients

Locations

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

505 Montgomery St
Fl 10
San Francisco, CA 94111
Phone (503) 427-8095

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

12710 SE Division St
Portland, OR 97236
Phone (503) 988-3410

780 Commercial St SE
Ste 100
Salem, OR 97301
Phone (469) 466-7037

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: bsmith247055@direct.ochin.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1801184601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 SW WASHINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052327",
            "telephone_number": "650-937-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 SW WASHINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052327",
            "telephone_number": "650-937-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-13",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "OR",
            "license": "185564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.