Cascade Spine Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

071546 Issued in OR

Legal business name

CASCADE SPINE CENTER, LLC

Practice address

6464 SW Borland Rd
BLDG a Ste a-3
Tualatin, OR 97062-8876

Phone

(971) 404-3366

Fax

(971) 404-3377

NPI assigned

Jun 17, 2005

Last updated

Sep 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric Boon

Title

Offiicer/Authorized Official

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Cascade Spine Center LLCCCN 38C0001054

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Baylor University Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Dallas, TX
  • NPI 1518967231

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  dba Baptist Health System

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1801891668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6464 SW BORLAND RD",
            "address_2": "BLDG A STE A-3",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628876",
            "telephone_number": "971-404-3366",
            "fax_number": "971-404-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6464 SW BORLAND RD",
            "address_2": "BLDG A STE A-3",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628876",
            "telephone_number": "971-404-3366",
            "fax_number": "971-404-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE SPINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-17",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFIICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "071546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00082443",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299326",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marcus Paul Carr, M.D.
• Patricia Ann Carroll, RN, LPC
• Cascade Occupational Medicine Physicians Inc
• Cascade Orthopaedic Group, P.C.
• Cascade Physicians, P.C.
• Joanna T Cashman, RN
• Bryan J Casper, PT
• Hannah Lee Casselton, PT, DPT,CLT
• Ryan Cate, PA
• Center Pharmacy & Sterile Products Inc

• Ambulatory Surgical Clinic/Center in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.