Active NPI
Brian Denney Becker Broncheau, M.D.
- Psychiatry Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD165987
- Practice address
- 5251 NE Glisan St
BLDG a, 2ND Floor
Portland, OR 97213-3052 - Phone
- (503) 215-4860
- NPI assigned
- Jun 30, 2009
- Last updated
- Sep 24, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Psychiatry Physician | 2084P0800X | 050297 | CT | |
| Psychiatry Physician | 2084P0800X | MD165987 | OR | Primary |
Addresses
Primary practice location
5251 NE Glisan St
BLDG a, 2ND Floor
Portland, OR 97213-3052
Mailing address
PO Box 3158
Portland, OR 97208-3158
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500677178 | Medicaid | OR |
Other names 1
- Brian Denney Becker
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bbeckerbroncheau445629@oc.providencedirect.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Oregon Health Sciences University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250
9155 SW Barnes Rd
Suite 238
Portland, OR 97225-6629
Phone (503) 216-0246
9205 SW Barnes Rd
Portland, OR 97225-6603
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050297 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Psychiatry | Current | Accepting new patients |
| Providence Health & Services Oregon | Psychiatry | Past | Accepting new patients |
| Providence Health & Services - Oregon | Past | Accepting new patients |
Locations
1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250
9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Providence Medical Group
- General Practice Physician
- Lake Oswego, OR
- NPI 1023488343
-
dba Providence Medical Group
- Psychiatry Physician
- Portland, OR
- NPI 1760177737
-
dba Providence Medical Group
- Internal Medicine Physician
- Sherwood, OR
- NPI 1184729329
-
dba Providence Medical Group
- Adult Mental Health Clinic/Center
- Portland, OR
- NPI 1093963209
Psychiatry
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence St Vincent Medical Center
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600905600000",
"number": "1821226713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5251 NE GLISAN ST",
"address_2": "BLDG A, 2ND FLOOR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972133052",
"telephone_number": "503-215-4860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER BRONCHEAU",
"first_name": "BRIAN",
"middle_name": "DENNEY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-30",
"last_updated": "2020-09-24",
"certification_date": "2020-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "050297",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "MD165987",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500677178",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bbeckerbroncheau445629@oc.providencedirect.org",
"affiliation": "N",
"address_1": "9205 SW Barnes Rd",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972256603",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "BRIAN",
"last_name": "BECKER",
"middle_name": "DENNEY",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.