East Portland Medical Associates LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD16449 Issued in OR

Legal business name

EAST PORTLAND MEDICAL ASSOCIATES LLC

Practice address

7524 SE Milwaukie Ave
Portland, OR 97202-6113

Phone

(503) 230-4811

Fax

(503) 249-1872

NPI assigned

Jan 29, 2008

Organization subpart

No

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

Authorized official

Name

Bertram Berney, MD

Title

Owner

Phone

(503) 230-4811

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Milton Louis Blettel, MD

  • Internal Medicine Physician
  • Tigard, OR
  • NPI 1336208388
  NPD (past)
• Tracy Walker, MD

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1871607234
  NPD (past)

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545177600000",
    "number": "1922285238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7524 SE MILWAUKIE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972026113",
            "telephone_number": "503-230-4811",
            "fax_number": "503-249-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7524 SE MILWAUKIE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972026113",
            "telephone_number": "503-230-4811",
            "fax_number": "503-249-1872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10248 NE Holladay St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97220",
            "country_code": "US",
            "telephone_number": "503-230-4811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4410 NE Glisan St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972132331",
            "country_code": "US",
            "telephone_number": "503-230-4811",
            "fax_number": "503-249-1872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST PORTLAND MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2018-12-19",
        "status": "A",
        "authorized_official_last_name": "BERNEY",
        "authorized_official_first_name": "BERTRAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-230-4811",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD16449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP PROVIDER #",
            "identifier": "110398",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Easlick
• East by Northwest Integrative Medicine
• East City Dental
• East Meets West Acupuncture and Massage, LLC
• East Portland Dentistry
• East Portland Neurology Clinic PC
• East Portland Optical Service
• East Portland Pediatric Clinic, P.C.
• East Portland Peritoneal Dialysis Clinic, LLC
• East Portland Surgical Center LLC

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.