Individual provider Active NPI

Cassandra Michelle Niemi, MD

  • Gynecologic Oncology Physician
  • Portland, OR
National Provider Identifier
1861781767
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
MD186977 Issued in OR
Practice address
4805 NE Glisan St Ste 11N
Portland, OR 97213-2933
Phone
(503) 215-2075
NPI assigned
Mar 31, 2011
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X MD186977 OR Primary

Addresses

Primary practice location

4805 NE Glisan St Ste 11N
Portland, OR 97213-2933

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

9555 SW Barnes Rd Ste 150
Portland, OR 97225-6691
Phone (503) 297-7403

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cniemi194120@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180807003894 WA Practitioner - Gynecological Oncology 3476708470 Reassigns benefits to 2 organizations
I20180807003952 OR Practitioner - Obstetrics/Gynecology 3476708470 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2021 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Feb 27, 2023 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2021 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2021 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Feb 27, 2023 Accepting new patients
Legacy Clinics LLC CurrentSince Feb 23, 2023 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2021 Accepting new patients
Legacy Clinics LLC CurrentSince Feb 23, 2023 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

1130 NW 22nd Ave
Ste 110
Portland, OR 97210
Phone (503) 413-3940

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

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

4805 NE Glisan St
Ste 11N
Portland, OR 97213
Phone (503) 215-1350

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

9135 SW Barnes Rd
Ste 261
Portland, OR 97225
Phone (503) 215-8650

19260 SW 65th Ave
Ste 400
Tualatin, OR 97062
Phone (503) 413-8654

2121 NE 139th St
Ste 120
Vancouver, WA 98686
Phone (360) 487-1717

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 11

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 5

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": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1861781767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST STE 11N",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-2075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9555 SW Barnes Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256691",
            "country_code": "US",
            "telephone_number": "503-297-7403",
            "fax_number": "503-384-9908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEMI",
        "first_name": "CASSANDRA",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "OR",
            "license": "MD186977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cniemi194120@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4805 NE Glisan St Ste 11N",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.