NPIMap

Organization Active NPI

Portland Adventist Medical Center

Doing business as Adventist Health Portland

  • General Acute Care Hospital
  • Portland, OR
National Provider Identifier
1801887658
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
14 1127 Issued in OR
Legal business name
PORTLAND ADVENTIST MEDICAL CENTER
Doing business as
Adventist Health Portland
Practice address
10123 SE Market St
Portland, OR 97216
Phone
(503) 257-2500
Fax
(503) 261-6637
NPI assigned
Nov 1, 2005
Last updated
Sep 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
Jason Panasuk
Title
Finance Officer
Phone
(503) 261-4405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 14 1127 OR Primary

Addresses

Primary practice location

10123 SE Market St
Portland, OR 97216

Mailing address

PO Box 888885
Los Angeles, CA 90088-8885
Phone (503) 257-2500

Other identifiers 1

IdentifierTypeStateIssuer
158253MedicaidOR

Other names 1

  • Adventist Health Portland Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030502000015 OR Part A Provider - Hospital 7012827876 Practice locations: Portland, OR; Troutdale, OR; Sandy, OR; Gresham, OR; Damascus, OR; Clackamas, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801887658. Details of each certification follow.

Hospital certification: CCN 380060

Legal name
PORTLAND ADVENTIST MEDICAL CENTER
Doing business as
ADVENTIST HEALTH PORTLAND
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 24, 2007
Beds
302
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Aug 13, 1923 in OR
Enrollment address
10123 SE Market St
Portland, OR 97216-2532
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Adventist Health PortlandCCN 380060 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Town Center Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1010 W Grangeville Blvd
Hanford, CA 93230
Phone (559) 584-3000

1524 W Lacey Blvd
Hanford, CA 93230
Phone (559) 537-0315

10201 SE Main St
Ste 24
Portland, OR 97216

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kyle a King Individual Corporate OfficerCeo Oct 9, 2020
W-2 Managing EmployeeCeo Oct 9, 2020
Kerry L Heinrich Individual Corporate OfficerChair of the Board Jan 1, 2022
Corporate Director Dec 16, 2014
John H Cress Individual Corporate DirectorBoard Member Oct 1, 2024
Meredith S Jobe Individual Corporate OfficerSecretary Mar 31, 2014
Eric a Stevens Individual Corporate OfficerVice Chair Mar 5, 2025
Richard K Reiner Individual Corporate Director Jan 16, 2017
Joy a. Fehr Individual Corporate DirectorBoard Member Oct 1, 2020
Jonathan J Daggett Individual Corporate DirectorBoard Member Jan 1, 2024
Andrew R Davis Individual Corporate DirectorBoard Member May 5, 2017
Ann K Beckett Individual Corporate DirectorBoard Member Jan 1, 2024
Marc K Woodson Individual Corporate DirectorBoard Member Jan 1, 2019
John C Freedman Individual Corporate DirectorBoard Member Sep 26, 2016
Jack W Wagner Individual Corporate DirectorBoard Member Dec 1, 2022
Kenneth Jutzy Individual Corporate DirectorBoard Member Jan 1, 2024
Bradford C Newton Individual Corporate Director Aug 16, 2021
Robert a Cherry Individual Corporate DirectorBoard Member May 5, 2017
Jason Panasuk Individual Corporate OfficerFinance Officer Nov 27, 2022
W-2 Managing EmployeeFinance Officer Nov 27, 2022
Larry L Innocent Individual Corporate DirectorBoard Member Sep 19, 2011
Adventist Health System/West Organization, Roseville, CA Corporation, Non-profit Operational/Managerial Control Jun 16, 1980 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 105

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 105

Subparts reporting this organization as parent 11

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 62

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 62

Affiliated clinicians 647

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 647

NPI Registry JSON

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1801887658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888885",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900888885",
            "telephone_number": "503-257-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10123 SE MARKET ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97216",
            "telephone_number": "503-257-2500",
            "fax_number": "503-261-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND ADVENTIST MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "PANASUK",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "FINANCE OFFICER",
        "authorized_official_telephone_number": "503-261-4405"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OR",
            "license": "14 1127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158253",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10123 SE Market St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Adventist Health Portland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.