Providence Health Sys-OR Shared Svs Div – Home Health Agency, NPI 1487746491

Providence Health Sys-OR Shared Svs Div is a healthcare provider. based in Portland, Oregon. specializing in Home Health Agency. The organization holds a License No. 13-140734 (OR). The NPI Number for Providence Health Sys-OR Shared Svs Div is 1487746491

Main info

Organization
Name
Providence Health Sys-OR Shared Svs Div
NPI
1487746491
Phone
(503) 215-4601
Address
4400 NE HALSEY ST
Authorized Official
DONALD WAYNE ANDERSON JR. ASSISTANT SECRETARY OF ENROLLMENTS
Enumeration Date
28 September 2006
Last Update Date
15 May 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Providence Health Sys-OR Shared Svs Div

  • Providence Office Park Building 2, 4400, Northeast Halsey Street, Hollywood, Portland, Metro, Multnomah County, Oregon, 97213-1422, United States

    BUILDING 1, STE 129

    PORTLAND, OR 972131545

    Phone: (503) 215-4601

    Fax: (503) 215-4624

    Type: Mailing

  • 2033, Commerce Drive, Medford, Jackson County, Oregon, 97504, United States

    MEDFORD, OR 975049744

    Phone: (541) 732-6500

    Fax: (541) 732-6504

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-12-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20141217000873OHome Health AgencyORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97213)

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Reviews

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Frequently asked questions

What is the standard ID for Providence Health Sys-OR Shared Svs Div in the U.S.?
In the U.S., Providence Health Sys-OR Shared Svs Div is identified by NPI 1487746491.
Does the public listing show Providence Health Sys-OR Shared Svs Div as active?
Providence Health Sys-OR Shared Svs Div's NPI record reflects an active status in NPPES.
Which specialty label fits Providence Health Sys-OR Shared Svs Div?
NPPES ties Providence Health Sys-OR Shared Svs Div to Home Health Agency in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Providence Health Sys-OR Shared Svs Div tied to Portland, Oregon?
If you are local to Portland, Oregon, Providence Health Sys-OR Shared Svs Div may be relevant to your search.
Why is information missing for Providence Health Sys-OR Shared Svs Div?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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