Active NPI
Susan J Leclair, MD
- Anesthesiology Physician
- Portland, OR
National Provider Identifier
1891718003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD22902
- Practice address
- 707 SW Washington St
Ste 700
Portland, OR 97205-3536 - Phone
- (503) 299-9906
- Fax
- (503) 225-9002
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD22902 | OR | Primary |
Addresses
Primary practice location
707 SW Washington St
Ste 700
Portland, OR 97205-3536
Mailing address
PO Box 2040
Portland, OR 97208-2040
Phone (503) 299-9906
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD078OR | Medicaid | AK | |
| 050083265 | Other | OR | RR MEDICARE |
| 806683500 | Medicaid | ID | |
| 287531 | Medicaid | OR | |
| 8280646 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oag Trauma Services LLC | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
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": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378771200000",
"number": "1891718003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2040",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972082040",
"telephone_number": "503-299-9906",
"fax_number": "503-225-9002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 SW WASHINGTON ST",
"address_2": "STE 700",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972053536",
"telephone_number": "503-299-9906",
"fax_number": "503-225-9002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LECLAIR",
"first_name": "SUSAN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2013-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OR",
"license": "MD22902",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD078OR",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "050083265",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806683500",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "287531",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8280646",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.