Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jay C. P. Jan, MD

Individual provider Surgery Physician · NPI 1417949926

Jay C. P. Jan, MD is a General Surgery in Portland, Oregon. Graduated from Jefferson Medical College of Thomas Jefferson University in 1996, 30 years ago. Practices with Legacy Clinics LLC, a 718-clinician group and accepts Medicare assignment. Licensed in Oregon and Washington.

Years since qualifying
30
Trained at
Jefferson Medical College of Thomas Jefferson University
Licensed in
OR, WA
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1130 NW 22nd Ave Ste 500
Portland, OR 97210-2900
Phone: (503) 413-5725
Fax: (503) 413-5726
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence MD24533 (OR)
Surgery Physician Taxonomy 208600000X · Licence MD00047700 (WA)

Record details

NPI number1417949926
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 19, 2005
Last updated in NPPESMarch 19, 2013
Mailing address1130 Nw 22nd Ave, Suite 500, Portland, OR 97210-2900

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolJEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduated 1996 (30 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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