GREATER PORTLAND NEUROSURGICAL CENTER, PC (NPI# 1033451265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033451265 |
| Entity Type | Organization |
| Organization Name | GREATER PORTLAND NEUROSURGICAL CENTER, PC |
| Practice Address |
24900 Se Stark St Ste 209 Gresham OR 97030-3382 |
| Practice Telephone | 5036655522 |
| Practice Fax Number | 5036658822 |
| Mailing Telephone | 5036655522 |
| Mailing Fax Number | 5036658822 |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-08-15 |
| Authorized Official Name | DR. JULIO ORDONEZ (OWNER) |
| Authorized Official Telephone | 5036655522 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | MD11164 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 192138 | 05 | |
| OR | PROVIDER TRANSACTION ACCESS NUMBER (PTAN) | R169208 | 01 |
| Street Address |
24900 SE STARK ST STE 209 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-3382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942552062 | Richard S Polin PC | Neurological Surgery | 24900 Se Stark St, Suite 208, Gresham, OR 97030-3355 | 2012-10-12 |
| 1386602266 | Julio A Ordonez | Neurological Surgery | 24900 Se Stark, Suite 209, Gresham, OR 97030-3382 | 2006-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063909737 | Norwyn Robert Newby | Neurological Surgery | 3054 Nw Duffy Dr, Bend, OR 97703-5485 | 2018-04-18 |
| 1447764485 | Columbia Neurosurgical Trauma, LLC | Neurological Surgery | 1040 Nw 22nd Ave Ste 630, Portland, OR 97210-3041 | 2017-11-29 |
| 1194178590 | Philippe Magown | Neurological Surgery | 3303 Sw Bond Ave # Ch8n, Department of Neurological Surgery, Ohsu, Portland, OR 97239-4501 | 2016-07-20 |
| 1922475813 | Willliam Leonard Debolt | Neurological Surgery | 7419 Nw Cornell Rd, Portland, OR 97229-6901 | 2015-08-26 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| 1366860009 | Kathryn Wagner | Neurological Surgery | 3101 Sw 13th Ave Apt 19, Portland, OR 97239-3071 | 2014-03-31 |
| 1699038323 | James Steve Heiden | Neurological Surgery | 2496 Nw 141st Pl, Portland, OR 97229-7078 | 2012-06-18 |
| 1467725713 | Gerard Joseph Voelkers Jr. | Neurological Surgery | 130 S Drift Creek Camp Rd, Lincoln City, OR 97367-9768 | 2012-02-17 |
| 1942578026 | Nw Neurosurgery LLC | Neurological Surgery | 311 Nw 12th Ave Unit 1003, Portland, OR 97209-2995 | 2011-12-05 |
| 1760718456 | John D. White | Neurological Surgery | 3582 El Dorado Loop S, Salem, OR 97302-9723 | 2009-10-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.