Active NPI
Richard Sanders Polin, MD
- Neurological Surgery Physician
- Clackamas, OR
National Provider Identifier
1043373996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- MD25930
- Practice address
- 9800 SE Sunnyside Rd
Clackamas, OR 97015-9750 - Phone
- (503) 571-6142
- Fax
- (503) 571-3601
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | MD25930 | OR | Primary |
| Neurological Surgery Physician | 207T00000X | MD00045150 | WA |
Addresses
Primary practice location
9800 SE Sunnyside Rd
Clackamas, OR 97015-9750
Mailing address
4324 SW Greenleaf Dr
Portland, OR 97221-3228
Phone (503) 227-3722
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060301000358 | OR | Practitioner - Neurosurgery | 5193731024 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- University of Virginia School of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1717 NE 42ND Ave
Suite 3300
Portland, OR 97213-1526
Phone (503) 666-8149
Hospital & facility affiliations
- Providence Portland Medical Center
- Peacehealth Southwest Medical Cente
- Adventist Health Portland
- Legacy Mount Hood Medical Center
- Providence Willamette Falls Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 55 |
| Laminectomy or laminotomy (partial removal of spine bones) | 39 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00045150 | WA | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard S Polin PC | Neurological Surgery | Current | Accepting new patients |
| Eastside Foot and Ankle | Current | Accepting new patients |
Locations
1717 NE 42nd Ave
Ste 3300
Portland, OR 97213
Phone (503) 284-2000
Interoperability endpoints
- richard.polin.1@22323.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Neurological Surgery Physician
- Gresham, OR
- NPI 1942552062
Neurological Surgery, OR
-
- Foot & Ankle Surgery Podiatrist
- Portland, OR
- NPI 1669884003
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003991845
Hospital
-
- Case Manager/Care Coordinator
- Portland, OR
- NPI 1891822995
Hospital
-
- General Acute Care Hospital
- Oregon City, OR
- NPI 1912282369
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043373996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4324 SW GREENLEAF DR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972213228",
"telephone_number": "503-227-3722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9800 SE SUNNYSIDE RD",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970159750",
"telephone_number": "503-571-6142",
"fax_number": "503-571-3601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLIN",
"first_name": "RICHARD",
"middle_name": "SANDERS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "OR",
"license": "MD25930",
"primary": true
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "WA",
"license": "MD00045150",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.