NPIMap

Individual provider Active NPI

Brian T Little, D.O.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1912987009
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO153217 Issued in OR
Practice address
1321 NE 99TH Ave Ste 100
Portland, OR 97220-9437
Phone
(503) 215-4050
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MB07614600 NJ
Internal Medicine Physician 207R00000X DO153217 OR Primary

Addresses

Primary practice location

1321 NE 99TH Ave Ste 100
Portland, OR 97220-9437

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

301 Spring Garden Rd
Hammonton, NJ 08037-2516
Phone (609) 567-7281

Other identifiers 1

IdentifierTypeStateIssuer
0014621MedicaidNJ

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
I20110321000779 OR Practitioner - Internal Medicine 9436142437 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1321 NE 99TH Ave
Suite 100
Portland, OR 97220-9437
Phone (503) 215-9900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB07614600NJMDInternal Medicine Physician
DO153217ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Mar 1, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Mar 1, 2020 Accepting new patients
Providence Health & Services - Oregon CurrentSince Mar 1, 2020 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Rowan Integrated Special Needs Internal Medicine PastSince May 1, 2019 Accepting new patients
Providence Health & Services - Oregon Internal Medicine Past Accepting new patients

Locations

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

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

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

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

Organizations & group practices 7

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 4

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1912987009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 NE 99TH AVE STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209437",
            "telephone_number": "503-215-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Spring Garden Rd",
            "address_purpose": "LOCATION",
            "city": "Hammonton",
            "state": "NJ",
            "postal_code": "080372516",
            "country_code": "US",
            "telephone_number": "609-567-7281",
            "fax_number": "609-561-2509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "BRIAN",
        "middle_name": "T",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MB07614600",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO153217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014621",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.