Individual provider Active NPI

Alice S Weston, M.D.

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1902190820
Registry record updated May 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD163182 Issued in OR
Practice address
4104 SE 82ND Ave
Suite 250
Portland, OR 97266-2954
Phone
(503) 215-9850
NPI assigned
Jun 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2017

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 MD163182 OR Primary

Addresses

Primary practice location

4104 SE 82ND Ave
Suite 250
Portland, OR 97266-2954

Mailing address

4104 SE 82ND Ave
Suite 250
Portland, OR 97266-2954
Phone (503) 215-9850

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
I20131218001844 OR Practitioner - Family Practice 7012158330 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York Medical College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

9290 SE Sunnybrook Blvd
Suite 120
Clackamas, OR 97015-6802
Phone (503) 215-2110

Hospital & facility affiliations

  • Providence Home Health Home health agency, Portland, OR, CCN 387048
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 16, 2017 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 16, 2017 Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 1, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 1, 2015 Accepting new patients

Locations

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

16180 SE Sunnyside Rd
Ste 102
Happy Valley, OR 97015
Phone (503) 582-4900

1321 NE 99th Ave
Ste 100
Portland, OR 97220
Phone (503) 215-4050

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

4104 SE 82nd Ave
Ste 250
Portland, OR 97266
Phone (503) 215-9850

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494633600000",
    "number": "1902190820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 SE 82ND AVE",
            "address_2": "SUITE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662954",
            "telephone_number": "503-215-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 SE 82ND AVE",
            "address_2": "SUITE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662954",
            "telephone_number": "503-215-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTON",
        "first_name": "ALICE",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2017-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD163182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.