Individual provider Active NPI

Brian Bizub, MD

  • Family Medicine Physician
  • Clackamas, OR
National Provider Identifier
1891377784
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD219786 Issued in OR
Practice address
9775 SE Sunnyside Rd Ste 200
Clackamas, OR 97015-5721
Phone
(503) 655-8471
NPI assigned
Apr 21, 2021
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD219786 OR Primary

Addresses

Primary practice location

9775 SE Sunnyside Rd Ste 200
Clackamas, OR 97015-5721

Mailing address

9775 SE Sunnyside Rd Ste 200
Clackamas, OR 97015-5721
Phone (503) 655-8471

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
I20241030000179 OR Practitioner - Family Practice 6800297185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

110 Beavercreek Rd
Oregon City, OR 97045-4307
Phone (503) 655-8471

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD219786ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Clackamas Office of County Auditor CurrentSince Apr 7, 2025 Accepting new patients
Clackamas County Current Accepting new patients
Clackamas County CurrentSince Apr 7, 2025 Accepting new patients

Locations

9775 SE Sunnyside Rd
Ste 200
Clackamas, OR 97015
Phone (503) 794-3830

110 Beavercreek Rd
Oregon City, OR 97045
Phone (503) 475-5558

110 Beavercreek Rd
Ste 100
Oregon City, OR 97045
Phone (503) 655-8374

2051 Kaen Rd
Ste 367
Oregon City, OR 97045
Phone (503) 742-5300

39740 Pleasant St
Sandy, OR 97055
Phone (503) 563-7679

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1891377784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9775 SE SUNNYSIDE RD STE 200",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155721",
            "telephone_number": "503-655-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9775 SE SUNNYSIDE RD STE 200",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155721",
            "telephone_number": "503-655-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIZUB",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD219786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.