NPIMap

Individual provider Active NPI

Ryland Samuel Stucke, M.D.

  • Surgery Physician
  • Portland, OR
National Provider Identifier
1922419688
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD198288 Issued in OR
Practice address
3303 S Bond Ave
Portland, OR 97239-4501
Phone
(503) 494-4373
Fax
(503) 418-4189
NPI assigned
May 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD198288 OR Primary

Addresses

Primary practice location

3303 S Bond Ave
Portland, OR 97239-4501

Mailing address

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-4373

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
I20200717002745 OR Practitioner - General Surgery 8820398738 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Oregon Health Sciences University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland Adventist Medical CenterGroup PAC ID 3274908819, 273 clinicians

Practice addresses (Care Compare)

10000 SE Main St
Suite 316
Portland, OR 97216-2470
Phone (503) 256-1575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
62.39
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD198288ORMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Adventist Medical Center CurrentSince Aug 30, 2021 Accepting new patients
Columbia Lutheran Charities Current Accepting new patients
Columbia Lutheran Charities Surgery CurrentSince Dec 1, 2022 Accepting new patients
Portland Adventist Medical Center Surgery CurrentSince Jul 9, 2023 Accepting new patients
Portland Adventist Medical Center CurrentSince Jul 9, 2023 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Aug 1, 2020 Accepting new patients
Columbia Lutheran Charities CurrentSince Dec 1, 2022 Accepting new patients
Portland Adventist Medical Center CurrentSince Aug 30, 2021 Accepting new patients
University Professional Services CurrentSince Aug 1, 2020 Accepting new patients
University Professional Services Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients
Portland Adventist Medical Center Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Locations

2111 Exchange St
Astoria, OR 97103
Phone (503) 325-4321

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

14450 SE Royer Rd
Damascus, OR 97089
Phone (503) 658-5521

10123 SE Market St
Portland, OR 97216
Phone (503) 251-6355

10000 SE Main St
Ste 316
Portland, OR 97216
Phone (503) 256-1575

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

Interoperability endpoints

  • Direct secure messaging: rstucke20725@direct.ohsu.edu

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1922419688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-4373",
            "fax_number": "503-418-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-4373",
            "fax_number": "503-418-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKE",
        "first_name": "RYLAND",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-15",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD198288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.