Organization Active NPI

Willamette General & Vascular Surgery, P.C.

  • Specialist
  • Tualatin, OR
National Provider Identifier
1881675973
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD19661 Issued in OR
Legal business name
WILLAMETTE GENERAL & VASCULAR SURGERY, P.C.
Practice address
19875 SW 65TH Ave
Suite 260
Tualatin, OR 97062-8353
Phone
(503) 691-1743
Fax
(503) 691-0983
NPI assigned
Nov 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
Dr. Patrick G McBee, M.D.NPI 1356474910
Title
Owner/Physician
Phone
(503) 691-1743

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MD19661 OR Primary

Addresses

Primary practice location

19875 SW 65TH Ave
Suite 260
Tualatin, OR 97062-8353

Mailing address

19875 SW 65TH Ave
Suite 260
Tualatin, OR 97062-8353
Phone (503) 691-1743

Other identifiers 4

IdentifierTypeStateIssuer
1344830OtherORUNITED HEALTHCARE INS
5665089OtherORAETNA
077313MedicaidOR
1356474910OtherORSOLE PROVIDER NPI

Other names 1

  • Willamette Surgical Clinic, P.C. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121008000062 OR Part B Supplier - Clinic/Group Practice 2961651922 Receives reassigned benefits from 1 practitioner
Practice locations: Tualatin, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1881675973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19875 SW 65TH AVE",
            "address_2": "SUITE 260",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628353",
            "telephone_number": "503-691-1743",
            "fax_number": "503-691-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19875 SW 65TH AVE",
            "address_2": "SUITE 260",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628353",
            "telephone_number": "503-691-1743",
            "fax_number": "503-691-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE GENERAL & VASCULAR SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "MCBEE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "503-691-1743",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD19661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE INS",
            "identifier": "1344830",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5665089",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077313",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOLE PROVIDER NPI",
            "identifier": "1356474910",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willamette Surgical Clinic, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tualatin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.