Individual provider Active NPI

Cristian R. Vallejos, M.D.

  • Gastroenterology Physician
  • Portland, OR
National Provider Identifier
1033206594
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD27733 Issued in OR
Practice address
9701 SW Barnes Rd
Suite 300
Portland, OR 97225-6772
Phone
(503) 297-8081
Fax
(503) 292-6601
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD27733 OR Primary

Addresses

Primary practice location

9701 SW Barnes Rd
Suite 300
Portland, OR 97225-6772

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other identifiers 2

IdentifierTypeStateIssuer
241789MedicaidOR
2502569MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_gastro_west_front_desk_pool12223293@oc.providencedirect.org The Oregon Clinic PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080114000486 OR Practitioner - GastroenterologyPractitioner - Internal Medicine 4587745773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of California, San Diego School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

9701 SW Barnes
Suite 300
Portland, OR 97225-6689
Phone (503) 297-8081

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy48
Upper gastrointestinal (GI) endoscopy for acid reflux34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2016 Accepting new patients
The Oregon Clinic PC Gastroenterology CurrentSince Mar 31, 2008 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2016 Accepting new patients
The Oregon Clinic, PC CurrentSince Mar 31, 2008 Accepting new patients

Locations

9701 SW Barnes Rd
Ste 300
Portland, OR 97225
Phone (503) 297-8081

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

847 NE 19th Ave
Ste 300
Portland, OR 97232

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • Direct secure messaging: cvallejos102861@oc.providencedirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1033206594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 SW BARNES RD",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256772",
            "telephone_number": "503-297-8081",
            "fax_number": "503-292-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJOS",
        "first_name": "CRISTIAN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "MD27733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241789",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2502569",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_gastro_west_front_desk_pool12223293@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "9701 SW Barnes Rd",
            "address_2": "Suite 300",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.