Individual provider Active NPI

Loris Hwang Spencer, M. D.

  • Pediatric Adolescent Medicine Physician
  • Portland, OR
National Provider Identifier
1851579981
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MD221474 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 418-5700
Fax
(503) 418-5704
NPI assigned
Jan 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A60237 CA
General Practice Physician 208D00000X MD221474 OR
Pediatric Adolescent Medicine Physician 2080A0000X MD221474 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 418-5700

Other practice location 1

10833 Le Conte Ave
Los Angeles, CA 90095-0001
Phone (310) 825-0867

Other practice location 2

Ucsf Department Of Pediatrics
505 Parnassus Ave., #M969
San Francisco, CA 94143-0001
Phone (415) 353-2002

Other identifiers 2

IdentifierTypeStateIssuer
8209710MedicaidWA
A60237OtherCACA MEDICAL LICENSE

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
I20240913002739 OR Practitioner - Pediatric Medicine 8921130105 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60237CAMDPharmacist
A60237CAMDPediatrics Physician
MD221474ORMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Sep 1, 2024 Accepting new patients
University Professional Services CurrentSince Sep 1, 2024 Accepting new patients
University Professional Services General Practice Current Accepting new patients
University Professional Services Pediatrics Past Accepting new patients
Highline Medical Group Inc Pediatrics Past Accepting new patients
UCLA Medical Group Pediatrics Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

Interoperability endpoints

  • Direct secure messaging: lspencer179443@direct.ohsu.edu

Organizations & group practices 6

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": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1851579981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-5700",
            "fax_number": "503-418-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-5700",
            "fax_number": "503-418-5704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10833 Le Conte Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900950001",
            "country_code": "US",
            "telephone_number": "310-825-0867",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Ucsf Department Of Pediatrics",
            "address_2": "505 Parnassus Ave., #M969",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941430001",
            "country_code": "US",
            "telephone_number": "415-353-2002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "LORIS",
        "middle_name": "HWANG",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A60237",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OR",
            "license": "MD221474",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "OR",
            "license": "MD221474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8209710",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE",
            "identifier": "A60237",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.