Individual provider Active NPI

Matthew S Davis, M.D.

  • Psychiatry Physician
  • Portland, OR
National Provider Identifier
1902076342
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD175201 Issued in OR
Practice address
7000 SW Varns St
Portland, OR 97223-8145
Phone
(503) 749-0200
NPI assigned
Feb 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD60849018 WA
Psychiatry Physician 2084P0800X A98192 CA
Child & Adolescent Psychiatry Physician 2084P0804X MD60849018 WA
Child & Adolescent Psychiatry Physician 2084P0804X MD175201 OR
Child & Adolescent Psychiatry Physician 2084P0804X A98192 CA
Psychiatry Physician 2084P0800X MD175201 OR Primary

Addresses

Primary practice location

7000 SW Varns St
Portland, OR 97223-8145

Mailing address

944 NE Hazelfern PL
Portland, OR 97232-2628
Phone (626) 318-5854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 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
I20110209000292 CA Practitioner - Psychiatry 9133309172 Reassigns benefits to 1 organization
I20170210001766 OR Practitioner - Psychiatry 9133309172 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A98192CAMDChild & Adolescent Psychiatry Physician
MD60849018WAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince Jan 9, 2017 Accepting new patients
Alameda Health System CurrentSince Dec 21, 2015 Accepting new patients
Madrona Recovery Washington LLC CurrentSince Aug 4, 2024 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Alameda Health System CurrentSince Dec 21, 2015 Accepting new patients
Matthew S Davis MD PLLC Psychiatry Current Accepting new patients
Alameda Health System Current Accepting new patients
Legacy Emanuel Hospital & Health Center Psychiatry CurrentSince Jan 9, 2017 Accepting new patients
Madrona Recovery PastSince Sep 1, 2019 Accepting new patients

Locations

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1225 NE 2nd Ave
Portland, OR 97232
Phone (503) 413-5051

7000 SW Varns St
Tigard, OR 97223
Phone 5037490200 ext. 523

Organizations & group practices 9

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": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1902076342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 NE HAZELFERN PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322628",
            "telephone_number": "626-318-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 SW VARNS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238145",
            "telephone_number": "503-749-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MATTHEW",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-29",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60849018",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A98192",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD60849018",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OR",
            "license": "MD175201",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A98192",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD175201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.