Organization provider

TANASBOURNE PLASTIC SURGERY PC

Plastic Surgery Physician Medicare enrolled

TANASBOURNE PLASTIC SURGERY PC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1174708457, based in Portland, OR. It is classified under Plastic Surgery Physician.

Getting there

The practice address on file is 11790 SW BARNES RD STE 120, Portland, OR 97225. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

11790 SW BARNES RD STE 120, Portland, OR 97225 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
MD22413 OR Plastic Surgery Physician primary

This provider holds licence MD22413 issued in OR. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.

Medicare (PECOS)
Status
Approved
Provider type
Part B Supplier - Clinic/group Practice
PAC ID
4688710700
Enrollment ID
O20091005000005

Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

What Plastic Surgery covers

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. NUCC Health Care Provider Taxonomy, code 208200000X
Allopathic & Osteopathic Physicians Plastic Surgery

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.

NPI1174708457 valid check digit
Entity typeOrganization (NPI-2)
Enumeration dateJan 4, 2008
Last updatedMay 13, 2025
StatusActive
Practice address 11790 SW BARNES RD STE 120
Portland, OR 97225
(503) 297-9340
Fax (503) 200-5499
This record was updated on May 13, 2025, which is recent enough that the contact details are likely still accurate.

Number check

1174708457 passes the NPI check digit test The final digit 7 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 7 4 7 0 8 4 5
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 5 4 5 0 7 4 1

Sum = 53 · next multiple of 10 = 60 · check digit = 7 · actual last digit = 7

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1174708457?
NPI 1174708457 is the National Provider Identifier assigned to TANASBOURNE PLASTIC SURGERY PC in Portland, OR. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Plastic Surgery Physician cover?
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is…
How do I contact TANASBOURNE PLASTIC SURGERY PC?
The phone number on file with NPPES is (503) 297-9340, last updated May 13, 2025. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does TANASBOURNE PLASTIC SURGERY PC accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1174708457 a valid number?
Yes. 1174708457 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.