NPIMap

Organization Active NPI

Providence Health & Services Oregon

Doing business as Providence Home Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
National Provider Identifier
1831289826
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PROVIDENCE HEALTH & SERVICES OREGON
Doing business as
Providence Home Medical Equipment
Practice address
6410 NE Halsey St
Suite 500
Portland, OR 97213-4742
Phone
(503) 215-4663
Fax
(503) 215-4655
NPI assigned
Oct 13, 2006
Last updated
May 15, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PROVIDENCE HEALTH & SERVICES - OREGONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Authorized official

Name
Donald W Anderson Jr.
Title
Assistant Secretary of Enrollments
Phone
(425) 358-9786

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Oxygen Equipment & Supplies (DME) 332BX2000X NPC-0002697 OR

Addresses

Primary practice location

6410 NE Halsey St
Suite 500
Portland, OR 97213-4742

Mailing address

PO Box 5936a
Portland, OR 97228-5936
Phone (503) 215-4663

Other identifiers 1

IdentifierTypeStateIssuer
108837MedicaidOR

Other names 1

  • Providence Home Medical Equipment Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930013895 OR DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 6305755000 Practice locations: Portland, OR

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Prov Family Med-North P18 organizations share this tax ID, including this one
Part of
Providence Portland Medical Center

Other organizations with this tax ID 17

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

View all 17

Locations

1111 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 216-5435

9155 SW Barnes Rd
Ste 736
Portland, OR 97225
Phone (503) 215-4663

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1831289826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5936A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972285936",
            "telephone_number": "503-215-4663",
            "fax_number": "503-215-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 NE HALSEY ST",
            "address_2": "SUITE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972134742",
            "telephone_number": "503-215-4663",
            "fax_number": "503-215-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES OREGON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH & SERVICES - OREGON",
        "enumeration_date": "2006-10-13",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "OR",
            "license": "NPC-0002697",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108837",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Home Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Home Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.