Northwest Primary Care Group PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

NORTHWEST PRIMARY CARE GROUP PC

Practice address

12119 SE Stevens CT
Portland, OR 97266-8620

Phone

(503) 353-1278

Fax

(503) 353-1273

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Whitbeck

Title

Administrator

Phone

(503) 659-4777

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Northwest Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Northwest Primary Care Group PC

  • Family Medicine Physician
  • Happy Valley, OR
  • NPI 1043230972

  O20040219000947

  Same enrollment
• Northwest Primary Care Group PC

  • Internal Medicine Physician
  • Milwaukie, OR
  • NPI 1083638589

  O20040219000947

  Same enrollment
• Northwest Primary Care Group PC

  • Family Medicine Physician
  • Portland, OR
  • NPI 1144319658

  O20040219000947

  Same enrollment
• Northwest Primary Care Group PC

  • Family Medicine Physician
  • Milwaukie, OR
  • NPI 1801856737

  O20040219000947

  Same enrollment
• Northwest Primary Care Group, PC

  • Family Medicine Physician
  • Milwaukie, OR
  • NPI 1558572180

  O20040219000947

  Same enrollment

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1922028869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22075",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972692075",
            "telephone_number": "503-659-4777",
            "fax_number": "503-652-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12119 SE STEVENS CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972668620",
            "telephone_number": "503-353-1278",
            "fax_number": "503-353-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PRIMARY CARE GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "WHITBECK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-659-4777",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP PTAN",
            "identifier": "CE8055",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049072",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Northwest Periodontics and Dental Implants LLC
• Northwest Permanente
• Northwest Permanente, P.C.
• Northwest Physical Therapy Care, LLC
• Northwest Primary Care Group PC
• Northwest Psychiatric Group, PC
• Northwest Recovery Services LLC
• Northwest Regenerative Orthopedics
• Northwest Rehab Alliance
• Northwest Renal Clinic, Inc.

• Physical Medicine & Rehabilitation Physician in Portland, OR
• Providers in Portland, OR by specialty
• Physical Medicine & Rehabilitation Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.