NPIMap

Organization Active NPI

Oregon Health & Science University

Doing business as OHSU Intercultural Psychiatric Program (OHSU IPP)

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
National Provider Identifier
1851460638
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
OREGON HEALTH & SCIENCE UNIVERSITY
Doing business as
OHSU Intercultural Psychiatric Program (OHSU IPP)
Practice address
3181 SW Sam Jackson Park Rd
Mail Code Uhn-88, Attn. Liz Stevenson
Portland, OR 97239-3011
Phone
(503) 494-8744
Fax
(503) 494-8020
NPI assigned
Nov 7, 2006
Last updated
May 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Authorized official

Name
Joe E Robertson, MD
Title
President, Ohsu
Phone
(503) 494-8252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Mail Code Uhn-88, Attn. Liz Stevenson
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Mail Code Uhn-88, Attn. Liz Stevenson
Portland, OR 97239-3011
Phone (503) 494-8744

Other identifiers 1

IdentifierTypeStateIssuer
248450MedicaidOR

Other names 1

  • OHSU Intercultural Psychiatric Program (OHSU IPP) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121000929 OR Part B Supplier - Clinic/Group Practice 4284542945 Receives reassigned benefits from 88 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; La Grande, OR

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 38

Organizations listed as members of this organization in the National Provider Directory.

View all 38

Locations

3181 SW Sam Jackson Park Rd
#88
Portland, OR 97239
Phone (503) 494-6140

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1851460638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE UHN-88, ATTN. LIZ STEVENSON",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8744",
            "fax_number": "503-494-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE UHN-88, ATTN. LIZ STEVENSON",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8744",
            "fax_number": "503-494-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON HEALTH & SCIENCE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT, OHSU",
        "authorized_official_telephone_number": "503-494-8252",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "248450",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OHSU Intercultural Psychiatric Program (OHSU IPP)",
            "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 12, 2009; 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.