EAST PORTLAND SURGERY CENTER LLC – NPI #1417287137
Clinic/Center

EAST PORTLAND SURGERY CENTER LLC is an AHC clinic located in HAPPY VALLEY, OR. NPPES has assigned the NPI number 1417287137 to EAST PORTLAND SURGERY CENTER LLC on December 31, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was last updated on Sep 19, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EAST PORTLAND SURGERY CENTER LLC below.

NPI Profile for
EAST PORTLAND SURGERY CENTER LLC

NPI Number
1417287137
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EAST PORTLAND SURGERY CENTER LLC
Primary location
9200 SE 91ST AVE
SUITE 100
HAPPY VALLEY, OR 97086-3756
Phone: (503) 772-6160 Fax: (503) 772-6161
Mailing address
14201 DALLAS PKWY
DALLAS, TX 75254-2916
Phone: (469) 893-2500 Fax: (504) 322-3284
Organization Subpart
No
Authorized Official
ERIC BOON
MARKET PRESIDENT
Phone: (480) 567-0269
Updated
Certification Date
Sep 19, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for EAST PORTLAND SURGERY CENTER LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherRAILROAD MEDICAREORP00864506
medicaidOR500624087
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)
OR 07-1604

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service
Endpoint type
CONNECT URL
Endpoint Description
2.16.840.1.113883.3.667.2
Content Type
Affiliation
Y
Endpoint Location
100 N 6TH ST STE 900A,
MINNEAPOLIS, MN 77025-1669