Active NPI
Adena Zadourian, DO
- Surgery Physician
- Corvallis, OR
National Provider Identifier
1093408411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- PG216240
- Practice address
- 3600 NW Samaritan Dr
Corvallis, OR 97330-5472 - Phone
- (541) 768-5111
- NPI assigned
- May 31, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | PG216240 | OR | Primary |
Addresses
Primary practice location
3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Mailing address
3600 NW Samaritan Dr
Corvallis, OR 97330-5472
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 |
|---|---|---|---|---|
| I20230613003255 | OR | Order and Referring Only - General Surgery | 5092172684 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1093408411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 NW SAMARITAN DR",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973305472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 NW SAMARITAN DR",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973305472",
"telephone_number": "541-768-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZADOURIAN",
"first_name": "ADENA",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-31",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OR",
"license": "PG216240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.