NPIMap

Individual provider Active NPI

Brian Tihomir Pavic, M.D.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1972822195
Registry record updated May 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
PG151582 Issued in OR
Practice address
9205 SW Barnes Road, Suite 20
Portland, OR 97225
Phone
(530) 888-9076
NPI assigned
May 27, 2010
Last updated
May 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X PG151582 OR Primary

Addresses

Primary practice location

9205 SW Barnes Road, Suite 20
Portland, OR 97225

Mailing address

840 Croman Point
Auburn, CA 95603
Phone (530) 888-9076

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
I20130425000569 OR Practitioner - Internal Medicine 1254577869 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

19300 SW 65TH Ave
Meridian Park Hosp
Portland, OR 97062-7706
Phone (503) 692-1212

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

9205 SW Barnes Rd
Portland, OR 97225-6603

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PG151582ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Nov 24, 2023 Accepting new patients
Silverton Health Current Accepting new patients
Providence Health & Services Oregon CurrentSince Mar 10, 2013 Accepting new patients
Marquis Clinical Services LLC CurrentSince Mar 1, 2024 Accepting new patients
Silverton Health CurrentSince Mar 20, 2020 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Jul 1, 2013 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Nov 24, 2023 Accepting new patients
Legacy Clinics LLC CurrentSince Jul 1, 2013 Accepting new patients
Silverton Health CurrentSince Mar 20, 2020 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients

Locations

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

4560 SE International Way
Ste 100
Portland, OR 97222
Phone (971) 206-5129

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

9205 SW Barnes Rd
Ste 20
Portland, OR 97225
Phone (503) 216-2229

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

1321 NE 99th Ave
Ste 100
Portland, OR 97220
Phone (503) 215-4050

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274918400000",
    "number": "1972822195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 CROMAN POINT",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "95603",
            "telephone_number": "530-888-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES ROAD, SUITE 20",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "530-888-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVIC",
        "first_name": "BRIAN",
        "middle_name": "TIHOMIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-27",
        "last_updated": "2010-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "PG151582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.