Glen R Patrizio, MD

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

License

MD24391 Issued in OR

Practice address

1625 Woods CT Ste 102
Hood River, OR 97031-2919

Phone

(541) 436-2960

Fax

(541) 436-2961

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gpatrizio133414@direct.ohsu.edu

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Eden Hospice at Portland, LLC

  • Community Based Hospice Care Agency
  • Oregon City, OR
  • NPI 1902579840

  W-2 Managing Employee

  CMS ownership

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.

• Mid-Columbia Center for Living

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • The Dalles, OR
  • NPI 1699745794
  Medicare reassignment NPD
• Mid-Columbia Medical Center

  • General Practice Physician
  • The Dalles, OR
  • NPI 1053409599
  Medicare reassignment NPD
• Healthcare for the Mid-Columbia Region

  • Emergency Medicine Physician
  • The Dalles, OR
  • NPI 1497797856
  NPD
• Mid-Columbia Center for Living

  • Community/Behavioral Health Agency
  • The Dalles, OR
  • NPI 1275954513
  NPD
• Mid-Columbia Medical Center

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1154351336

  Family Medicine

  NPD
• Mid-Columbia Medical Center

  • Urology Physician
  • The Dalles, OR
  • NPI 1164735478
  NPD
• Columbia Gorge Children'S Advocacy Center

  • Public Health or Welfare Agency
  • Hood River, OR
  • NPI 1851698476
  NPD (past)
• Eden Hospice at Portland, LLC

  • Community Based Hospice Care Agency
  • Oregon City, OR
  • NPI 1902579840

  Family Medicine

  NPD (past)
• Mid-Columbia Center for Living

  • Community/Behavioral Health Agency
  • Hood River, OR
  • NPI 1831510155
  NPD (past)
• Mid-Columbia Medical Center

  • Critical Access Hospital Clinic/Center
  • The Dalles, OR
  • NPI 1306842752
  NPD (past)
• Mid-Columbia Medical Center

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1407887052

  Hospice and Palliative Medicine

  NPD (past)
• Seasons Medical Group of Oregon PC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1548774375
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1962484592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4355 W RIDGE DR",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970317734",
            "telephone_number": "541-705-7505",
            "fax_number": "971-244-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 WOODS CT STE 102",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970312919",
            "telephone_number": "541-436-2960",
            "fax_number": "541-436-2961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1610 Woods Ct",
            "address_purpose": "LOCATION",
            "city": "Hood River",
            "state": "OR",
            "postal_code": "970312911",
            "country_code": "US",
            "telephone_number": "541-296-5452",
            "fax_number": "541-296-1537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4355 W Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Hood River",
            "state": "OR",
            "postal_code": "970317734",
            "country_code": "US",
            "telephone_number": "541-705-7505",
            "fax_number": "971-244-9050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1060 Webber St",
            "address_purpose": "LOCATION",
            "city": "The Dalles",
            "state": "OR",
            "postal_code": "970583749",
            "country_code": "US",
            "telephone_number": "541-296-5452",
            "fax_number": "541-296-1537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6500 S MacAdam Ave Ste 160",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393566",
            "country_code": "US",
            "telephone_number": "866-238-8010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 S Grady Way",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980573220",
            "country_code": "US",
            "telephone_number": "916-307-6458",
            "fax_number": "916-490-3712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRIZIO",
        "first_name": "GLEN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "OR",
            "license": "MD24391",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD24391",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "WA",
            "license": "MD60191672",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227266",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Parker
• Rebecca Parker
• Patrick O Freeman DDS PC
• Kiersten K Patrick
• Michele Lee Patrick, LMT
• Anya Katrin Patton, MS, LMHC
• Bret Paulus, PT
• Lisa Pearson, MD
• Laura Pederson, LMT
• Petrina Pedry

• Hospice and Palliative Medicine (Family Medicine) Physician in Hood River, OR
• Providers in Hood River, OR by specialty
• Hospice and Palliative Medicine (Family Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.