Individual provider Active NPI

Casey Peyton Homeyer, MD/MPH

  • Obstetrics Physician
  • Portland, OR
National Provider Identifier
1871989178
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
MD193740 Issued in OR
Practice address
3550 N Interstate Ave
Portland, OR 97227-1196
Phone
(285) 424-6855
NPI assigned
Apr 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X MD193740 OR Primary

Addresses

Primary practice location

3550 N Interstate Ave
Portland, OR 97227-1196

Mailing address

2150 NE Division St Ste 202
Gresham, OR 97030-5859
Phone (503) 667-4454

Other identifiers 2

IdentifierTypeStateIssuer
MD193740MedicaidOR
1871989178OtherORNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 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
I20190822000759 OR Practitioner - Obstetrics/Gynecology 7810204591 Reassigns benefits to 1 organization
I20200103000944 WA Practitioner - Obstetrics/Gynecology 7810204591 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 4, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 4, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 4, 2019 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3550 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 4

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1871989178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 NE DIVISION ST STE 202",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305859",
            "telephone_number": "503-667-4454",
            "fax_number": "503-666-3298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 N INTERSTATE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271196",
            "telephone_number": "285-424-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMEYER",
        "first_name": "CASEY",
        "middle_name": "PEYTON",
        "name_prefix": "Dr.",
        "credential": "MD/MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "OR",
            "license": "MD193740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD193740",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1871989178",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.