Individual provider Active NPI

Elizabeth Hatfield, DO

  • Emergency Medicine Physician
  • Portland, OR
National Provider Identifier
1104210921
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
PG183257 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd # CDW
Portland, OR 97239-3011
Phone
(503) 708-0723
NPI assigned
Mar 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X PG183257 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd # CDW
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd # CDW-Em
Portland, OR 97239-3011
Phone (503) 708-0723

Other practice location 1

200 Mullins Dr
Lebanon, OR 97355-3983
Phone (503) 708-0723

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
I20200819000683 OR Practitioner - Emergency Medicine 0042584922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.53 of 100Reported as group
Quality
96.2
Promoting interoperability
100
Improvement activities
40
Cost
84.49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Jul 13, 2020 Accepting new patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Jul 13, 2020 Accepting new patients

Locations

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

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.

Hospital & facility affiliations 2

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": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104210921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # CDW-EM",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-708-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # CDW",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-708-0723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Mullins Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973553983",
            "country_code": "US",
            "telephone_number": "503-708-0723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATFIELD",
        "first_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "PG183257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.