Lyle L Jobe, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD164491 Issued in OR

Practice address

55 NE Grand Ave
Portland, OR 97232-2968

Phone

(503) 232-1099

Fax

(503) 232-3669

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Telecare Mental Health Services of Oregon, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gresham, OR
  • NPI 1386767176
  Medicare reassignment NPD
• Telecare Mental Health Services of Oregon, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Gresham, OR
  • NPI 1740378371
  NPD
• Family Care for Children & Youth, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • York, PA
  • NPI 1689740839
  NPD (past)
• Philhaven

  • Psychiatric Hospital
  • Lebanon, PA
  • NPI 1972598076
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1912963299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17742 MARYLCREEK DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970344017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NE GRAND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322968",
            "telephone_number": "503-232-1099",
            "fax_number": "503-232-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOBE",
        "first_name": "LYLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OR",
            "license": "MD164491",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD164491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1552072",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50023461",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "802092",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inha Jo, DO
• Joan B. Baggett, MSW, Inc.
• Joanna K. May
• Julie Joannini
• Amalia Jobe
• Dennis R Jobes, RT (R,MR)
• Jena Jobin, PHARMD
• Jocelyn Kirnak, Inc.
• Kevin Patrick Jocham, MD
• Brian Jochim, DMD

• Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.