Optumcare Portland Llc - Medicare Primary Care in Portland, OR

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Optumcare Portland Llc is a medicare enrolled primary clinic (General Practice) in Portland, Oregon. The current practice location for Optumcare Portland Llc is 9450 Sw Barnes Rd Ste 100, Portland, Oregon. For appointments, you can reach them via phone at (503) 292-9560. The mailing address for Optumcare Portland Llc is 9450 Sw Barnes Rd Ste 100, Portland, Oregon and phone number is (503) 292-9560.

Optumcare Portland Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1710003140. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (503) 292-9560.

Contact Information

Optumcare Portland Llc
9450 Sw Barnes Rd Ste 100
Portland
OR 97225
(503) 292-9560
(503) 292-9510

Map and Direction


Primary Care Clinic Profile

Full NameOptumcare Portland Llc
SpecialityGeneral Practice
Location9450 Sw Barnes Rd Ste 100, Portland, Oregon
Authorized Official Name and PositionBrenda Castillo (REVENUE CYCLE MANAGER)
Authorized Official Contact5033842027
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Optumcare Portland Llc
9450 Sw Barnes Rd Ste 100
Portland
OR 97225-6642

Ph: (503) 292-9560		Optumcare Portland Llc
9450 Sw Barnes Rd Ste 100
Portland
OR 97225

Ph: (503) 292-9560

NPI Details:

NPI Number1710003140
Provider Enumeration Date03/21/2007
Last Update Date12/05/2022

Medicare PECOS Information:

Medicare PECOS PAC ID8820986441
Medicare Enrollment IDO20040305000933

Medical Identifiers

Medical identifiers for Optumcare Portland Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710003140NPI-NPPES
810029000OtherORREGENCE BLUE CROSS
DA6538OtherORMEDICARE RAILROAD GROUP

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208D00000XGeneral Practice (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Optumcare Portland Llc acts as a billing entity for following providers:
Provider NameLonnie L Smucker
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1548293087
PECOS PAC ID: 2062326614
Enrollment ID: I20031118000170
Provider NameCharles M Kilo
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1801869078
PECOS PAC ID: 0143118778
Enrollment ID: I20040316001292
Provider NameLeesa M Azar
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1629012315
PECOS PAC ID: 9436129244
Enrollment ID: I20040805001415
Provider NameTimothy O Brinker
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1700869484
PECOS PAC ID: 8325014079
Enrollment ID: I20040903000788
Provider NameNina Sanna
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801914635
PECOS PAC ID: 5496799686
Enrollment ID: I20050617000950
Provider NameLatha S Radhakrishnan
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1598787426
PECOS PAC ID: 3577583061
Enrollment ID: I20051129000742
Provider NameBj Scott
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1407892185
PECOS PAC ID: 6901807916
Enrollment ID: I20070117000525
Provider NameSusan M Vockert-burke
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245419399
PECOS PAC ID: 4486743218
Enrollment ID: I20071203000099
Provider NameEdgar Daniel Crawford
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1558399790
PECOS PAC ID: 6608060777
Enrollment ID: I20101102001336
Provider NameAnne N Skinner
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1528124120
PECOS PAC ID: 1557466729
Enrollment ID: I20101110000641
Provider NameMelissa Noble
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1629109335
PECOS PAC ID: 8628010766
Enrollment ID: I20140402000333
Provider NameEmi A Koda
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1619256021
PECOS PAC ID: 5799918421
Enrollment ID: I20140829000576
Provider NameKaylene M Meyer
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1275505398
PECOS PAC ID: 3678590825
Enrollment ID: I20141217002613
Provider NameSteven D Aguilu
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1851397830
PECOS PAC ID: 4385774686
Enrollment ID: I20150902000164
Provider NameIan M Horner
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1902245756
PECOS PAC ID: 2264676154
Enrollment ID: I20151021003179
Provider NameMay-lynn S Chu
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1780002626
PECOS PAC ID: 3173823192
Enrollment ID: I20170828001004
Provider NameStephanie Nicole D'andrea
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497125884
PECOS PAC ID: 0941589691
Enrollment ID: I20171227001565
Provider NamePaul S Ciechanowski
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1083704936
PECOS PAC ID: 6901930072
Enrollment ID: I20180927001641
Provider NameKatie Leigh Rogers
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1841752292
PECOS PAC ID: 1759616527
Enrollment ID: I20190716002413
Provider NameDaniel Rodgers
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1154778439
PECOS PAC ID: 8820375702
Enrollment ID: I20190723003678
Provider NameJason Monroe Stanley
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1013506864
PECOS PAC ID: 9436564242
Enrollment ID: I20210208002812
Provider NameAudrey Duguay
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1164978771
PECOS PAC ID: 2264848316
Enrollment ID: I20210315002611
Provider NameLisa Marie Newton- Klucevek
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1528155280
PECOS PAC ID: 0547669608
Enrollment ID: I20210524001275
Provider NameRaquel Rose
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1386097541
PECOS PAC ID: 5991084816
Enrollment ID: I20210622001398
Provider NameMatthew David Van Auken
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1528474806
PECOS PAC ID: 5294954285
Enrollment ID: I20220112002466
Provider NameErin Brewer Williams
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1609593276
PECOS PAC ID: 3678944352
Enrollment ID: I20230116000871
Provider NameIrena G Mattingly
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457040818
PECOS PAC ID: 9830558006
Enrollment ID: I20230706001063
Provider NameDakin Nicole Larro
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1982233730
PECOS PAC ID: 7113380965
Enrollment ID: I20230828002613

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.