Providence Connections Medical Group - Medicare Primary Care in Portland, OR

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Providence Connections Medical Group is a medicare enrolled primary clinic (Clinic/center) in Portland, Oregon. The current practice location for Providence Connections Medical Group is 6410 Ne Halsey St, Suite 300, Portland, Oregon. For appointments, you can reach them via phone at (503) 215-4691. The mailing address for Providence Connections Medical Group is Po Box 3158, Portland, Oregon and phone number is (503) 215-6494.

Providence Connections Medical Group is licensed to practice in Oregon (license number ). The clinic also participates in the medicare program and its NPI number is 1043366172. 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) 215-4691.

Contact Information

Providence Connections Medical Group
6410 Ne Halsey St
Suite 300
Portland
OR 97213-4749
(503) 215-4691
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameProvidence Connections Medical Group
SpecialityClinic/Center
Location6410 Ne Halsey St, Portland, Oregon
Authorized Official Name and PositionDonald W Anderson (ASST SEC FOR ENROLL/DIR REIMB ADMIN)
Authorized Official Contact4255255392
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Providence Connections Medical Group
Po Box 3158
Portland
OR 97208-3158

Ph: (503) 215-6494		Providence Connections Medical Group
6410 Ne Halsey St
Suite 300
Portland
OR 97213-4749

Ph: (503) 215-4691

NPI Details:

NPI Number1043366172
Provider Enumeration Date01/25/2007
Last Update Date11/21/2023

Medicare PECOS Information:

Medicare PECOS PAC ID6305755000
Medicare Enrollment IDO20040126000526

Medical Identifiers

Medical identifiers for Providence Connections Medical Group such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043366172NPI-NPPES
247685MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center (* (Not Available))Secondary
261Q00000XClinic/center (Oregon)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Providence Connections Medical Group acts as a billing entity for following providers:
Provider NameSharon F Lissman
Provider TypePractitioner - Hospice/palliative Care
Provider IdentifiersNPI Number: 1205871993
PECOS PAC ID: 4284626995
Enrollment ID: I20040401001205
Provider NameKaren A Rydell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1922090232
PECOS PAC ID: 9638195290
Enrollment ID: I20051021000948
Provider NameElise Newman
Provider TypePractitioner - Hospice/palliative Care
Provider IdentifiersNPI Number: 1659326098
PECOS PAC ID: 8224059233
Enrollment ID: I20051216000691
Provider NameLori Siegal
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1376656561
PECOS PAC ID: 2062434095
Enrollment ID: I20051219000839
Provider NameRichard T Warren
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134151822
PECOS PAC ID: 9638193725
Enrollment ID: I20060117000052
Provider NameElke P Lowenkopf
Provider TypePractitioner - Hospice/palliative Care
Provider IdentifiersNPI Number: 1548323009
PECOS PAC ID: 8921108093
Enrollment ID: I20070703000451
Provider NameMark R Rosenberg
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1922181106
PECOS PAC ID: 0446313084
Enrollment ID: I20090108000485
Provider NameTula Top
Provider TypePractitioner - Hospice/palliative Care
Provider IdentifiersNPI Number: 1346432721
PECOS PAC ID: 0840337473
Enrollment ID: I20091104000689
Provider NameAnne M Houff
Provider TypePractitioner - Hospice/palliative Care
Provider IdentifiersNPI Number: 1013116565
PECOS PAC ID: 2062606304
Enrollment ID: I20101101000984
Provider NamePatricia Fogarty
Provider TypePractitioner - Hospice/palliative Care
Provider IdentifiersNPI Number: 1801180260
PECOS PAC ID: 1557502978
Enrollment ID: I20140513002346
Provider NameHannah I Rose
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1174880470
PECOS PAC ID: 4789829631
Enrollment ID: I20150602001426
Provider NameCynthia L Wallace
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811393648
PECOS PAC ID: 7911219035
Enrollment ID: I20150702000790
Provider NameFrances A Derook
Provider TypePractitioner - Hospice/palliative Care
Provider IdentifiersNPI Number: 1922098060
PECOS PAC ID: 2668453929
Enrollment ID: I20151023001133
Provider NameRachel M Rackow
Provider TypePractitioner - Hospice/palliative Care
Provider IdentifiersNPI Number: 1285862565
PECOS PAC ID: 0547499238
Enrollment ID: I20160901000763
Provider NameBenjamin M Ware
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1922411404
PECOS PAC ID: 8022233196
Enrollment ID: I20160906002699
Provider NameChristine Erickson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619125689
PECOS PAC ID: 4789577503
Enrollment ID: I20170202000570
Provider NameLena K Hillenburg
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1710042502
PECOS PAC ID: 9335117795
Enrollment ID: I20170905000113
Provider NameKatherine A Mayers
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821584889
PECOS PAC ID: 4789919622
Enrollment ID: I20190715001059
Provider NameCaroline M Olney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174898795
PECOS PAC ID: 1951525039
Enrollment ID: I20200129001025
Provider NameJuan C Iregui
Provider TypePractitioner - Hospice/palliative Care
Provider IdentifiersNPI Number: 1336191618
PECOS PAC ID: 1254318009
Enrollment ID: I20220517002204
Provider NameMaryam M Saudagaran
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083248504
PECOS PAC ID: 8729466776
Enrollment ID: I20230825001975

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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.