Individual provider Active NPI

Bryce Bederka, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Portland, OR
National Provider Identifier
1831215987
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
MD27276 Issued in OR
Practice address
501 N Graham St Ste 200
Legacy Bone and Joint
Portland, OR 97227-2000
Phone
(503) 413-2492
Fax
(503) 413-1812
NPI assigned
Mar 21, 2007
Last updated
Jul 16, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X MD27276 OR Primary

Addresses

Primary practice location

501 N Graham St Ste 200
Legacy Bone and Joint
Portland, OR 97227-2000

Mailing address

501 N Graham St Ste 200
Legacy Bone and Joint
Portland, OR 97227-2000
Phone (503) 413-2492

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070802000036 OR Practitioner - Orthopedic Surgery 4789775982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711

1015 Nw22Nd Ave
Suite 34
Portland, OR 97210-3025
Phone (503) 413-6376

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

2222 NW Lovejoy St
Suite 411
Portland, OR 97210-5102
Phone (503) 413-5702

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-1122

450 N Graham St
Portland, OR 97227-1682
Phone (503) 413-4488

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD27276ORMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Aug 20, 2007 Accepting new patients
Legacy Clinics LLC Past Accepting new patients

Locations

1960 NW 167th Pl
Ste 200
Beaverton, OR 97006
Phone (503) 413-4488

501 N Graham St
Ste 200
Portland, OR 97227
Phone (503) 413-4488

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2222 NW Lovejoy St
Ste 419
Portland, OR 97210
Phone (503) 223-1933

450 N Graham St
Portland, OR 97227
Phone (503) 413-4161

475 S Columbia River Hwy
Ste 100
Saint Helens, OR 97051
Phone (503) 229-8455

Interoperability endpoints

  • Direct secure messaging: bbederka18196@direct.lhs.org

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1831215987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 200",
            "address_2": "LEGACY BONE AND JOINT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272000",
            "telephone_number": "503-413-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 200",
            "address_2": "LEGACY BONE AND JOINT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272000",
            "telephone_number": "503-413-2492",
            "fax_number": "503-413-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDERKA",
        "first_name": "BRYCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "OR",
            "license": "MD27276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.