Individual provider Active NPI

Brett Michael Rath, MD

  • Family Medicine Physician
  • Beaverton, OR
National Provider Identifier
1831280312
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD18890 Issued in OR
Practice address
15950 SW Millikan Way
Beaverton, OR 97006
Phone
(503) 646-0161
Fax
(503) 264-3745
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD18890 OR Primary

Addresses

Primary practice location

15950 SW Millikan Way
Beaverton, OR 97006

Mailing address

800 SW 13TH Ave
Portland, OR 97205-1902
Phone (503) 221-0161

Other identifiers 1

IdentifierTypeStateIssuer
073643MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brath1760@direct.theportlandclinic.net

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
I20110124001256 OR Practitioner - Family Practice 4284710039 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD18890ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Portland Clinic Laboratory Current Accepting new patients
Portland Clinic Family Medicine CurrentSince Jul 15, 1994 Accepting new patients

Locations

15950 SW Millikan Way
Beaverton, OR 97003
Phone (503) 646-0161

800 SW 13th Ave
Portland, OR 97205
Phone (503) 221-0161

6640 SW Redwood Ln
Portland, OR 97224
Phone (503) 620-7358

9250 SW Hall Blvd
Tigard, OR 97223
Phone (503) 221-0161

Interoperability endpoints

  • Direct secure messaging: brath1760@direct.theportlandclinic.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1831280312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051902",
            "telephone_number": "503-221-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15950 SW MILLIKAN WAY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97006",
            "telephone_number": "503-646-0161",
            "fax_number": "503-264-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATH",
        "first_name": "BRETT",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD18890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073643",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brath1760@direct.theportlandclinic.net",
            "affiliation": "N",
            "address_1": "15950 SW Millikan Way",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.