NPIMap

Organization Active NPI

Orthopedic & Sports Medicine Center of Oregon LLC

  • Orthopaedic Surgery Physician
  • Lake Oswego, OR
National Provider Identifier
1891734877
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPEDIC & SPORTS MEDICINE CENTER OF OREGON LLC
Practice address
17355 Lower Boones Ferry Rd
Ste 100a
Lake Oswego, OR 97035
Phone
(503) 224-8399
Fax
(503) 224-5661
NPI assigned
Jun 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Authorized official

Name
Kathy S Brown
Title
Controller
Phone
(503) 936-5632

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

17355 Lower Boones Ferry Rd
Ste 100a
Lake Oswego, OR 97035

Mailing address

17355 Lower Boones Ferry Rd
Ste 100a
Lake Oswego, OR 97035
Phone (503) 224-8399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041118000526 OR Part B Supplier - Clinic/Group Practice 3678537602 Receives reassigned benefits from 20 practitioners
Practice locations: Lake Oswego, OR
O20130516000120 OR DME Supplier - Physician - General Practice 3678537602 Practice locations: Lake Oswego, OR

National Provider Directory

National Provider Directory

Locations

17355 Boones Ferry Rd
Ste 100A
Lake Oswego, OR 97035
Phone (503) 256-5866

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1891734877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17355 LOWER BOONES FERRY RD",
            "address_2": "STE 100A",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97035",
            "telephone_number": "503-224-8399",
            "fax_number": "503-224-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17355 LOWER BOONES FERRY RD",
            "address_2": "STE 100A",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97035",
            "telephone_number": "503-224-8399",
            "fax_number": "503-224-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC & SPORTS MEDICINE CENTER OF OREGON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "503-936-5632"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.