NPIMap

Individual provider Active NPI

Eric J Macevoy, M.D., MBA

  • Family Medicine Physician
  • Tualatin, OR
National Provider Identifier
1912267816
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD173713 Issued in OR
Practice address
19875 SW 65TH Ave Ste 100
Tualatin, OR 97062-8353
Phone
(503) 692-7785
NPI assigned
May 24, 2012
Last updated
Jul 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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 MD173713 OR Primary

Addresses

Primary practice location

19875 SW 65TH Ave Ste 100
Tualatin, OR 97062-8353

Mailing address

PO Box 6689
Portland, OR 97228-6689
Phone (503) 413-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150827000803 OR Practitioner - Family Practice 3072825926 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Dental Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Meridian Park HospitalGroup PAC ID 5092609842, 113 clinicians

Practice addresses (Care Compare)

19300 SW 65TH Ave
Tualatin, OR 97062-7706
Phone (503) 413-4330

19875 SW 65TH Ave
Tualatin, OR 97062-8353
Phone (503) 692-7785

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Meridian Park Hospital CurrentSince Aug 31, 2015 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Aug 31, 2015 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Sep 15, 2024 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Sep 15, 2024 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Sep 15, 2024 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Sep 15, 2024 Accepting new patients
Legacy Clinics LLC CurrentSince Sep 15, 2024 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Clinics LLC Family Medicine CurrentSince Sep 15, 2024 Accepting new patients
Legacy Meridian Park Pediatric Rehab PastSince Jul 16, 2023 Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

500 N Columbia River Hwy
Ste 6
Saint Helens, OR 97051
Phone (503) 366-5101

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

19875 SW 65th Ave
Ste 100
Tualatin, OR 97062
Phone (503) 692-7785

Interoperability endpoints

  • Direct secure messaging: emacevoy122802@direct.lhs.org

Organizations & group practices 11

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.

Hospital & facility affiliations 3

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": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1912267816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6689",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972286689",
            "telephone_number": "503-413-3900",
            "fax_number": "503-413-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19875 SW 65TH AVE STE 100",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628353",
            "telephone_number": "503-692-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEVOY",
        "first_name": "ERIC",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D., MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD173713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

Verify at the official NPI Registry.