Individual provider Active NPI

Robbie Bahl, MD

  • Addiction Medicine (Family Medicine) Physician
  • Portland, OR
National Provider Identifier
1942469762
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
MD164885 Issued in OR
Practice address
3769 SE Milwaukie Ave
Portland, OR 97202-3804
Phone
(503) 206-8850
Fax
(503) 296-5820
NPI assigned
Jun 6, 2008
Last updated
Mar 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X MD164885 OR Primary

Addresses

Primary practice location

3769 SE Milwaukie Ave
Portland, OR 97202-3804

Mailing address

3769 SE Milwaukie Ave
Portland, OR 97202-3804
Phone (503) 206-8850

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140515001627 OR Practitioner - Addiction Medicine 8628215365 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Addiction Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3769 SE Milwaukie Ave
Portland, OR 97202-3804
Phone (503) 206-8850

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD164885ORMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robbie Bahl, MD LLC Addiction Medicine CurrentSince Jan 7, 2014 Accepting new patients
Ubh of Oregon, LLC CurrentSince Feb 18, 2014 Accepting new patients

Locations

10300 SW Eastridge St
Portland, OR 97225
Phone (503) 944-5000

3769 SE Milwaukie Ave
Portland, OR 97202
Phone (503) 206-8850

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1942469762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3769 SE MILWAUKIE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023804",
            "telephone_number": "503-206-8850",
            "fax_number": "503-296-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3769 SE MILWAUKIE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023804",
            "telephone_number": "503-206-8850",
            "fax_number": "503-296-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHL",
        "first_name": "ROBBIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "OR",
            "license": "MD164885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.