Active NPI
Rick Dewitt Pittman, MD
- Vascular Surgery Physician
- Salem, OR
National Provider Identifier
1104990175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- MD15726
- Practice address
- 1793 13TH St SE
Salem, OR 97302-2541 - Phone
- (503) 362-8385
- Fax
- (503) 362-8435
- NPI assigned
- Nov 20, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | MD15726 | OR | Primary |
Addresses
Primary practice location
1793 13TH St SE
Salem, OR 97302-2541
Mailing address
1793 13TH St SE
Salem, OR 97302-2541
Phone (503) 362-8385
Other practice location 1
1535 Liberty St SE
Salem, OR 97302-4345
Phone (503) 371-8346
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 049148 | Medicaid | OR |
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
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Oregon Health Sciences University School of Medicine, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1793 13TH St SE
Salem, OR 97302-2541
Phone (503) 362-8385
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.65 of 100
- Promoting interoperability
- 89
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 23 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15726 | OR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silver Falls Dermatology, LLC | Current | Accepting new patients | |
| Silver Falls Dermatology, LLC | Current | Accepting new patients | |
| Salem Vascular Consultants, LLP | Vascular Surgery | Past | Accepting new patients |
Locations
1390 Waverly Dr SE
Albany, OR 97322
Phone (541) 967-8385
1793 13th St SE
Salem, OR 97302
Phone 50336283851283
Organizations & group practices 3
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.
-
- Dermatology Physician
- Salem, OR
- NPI 1134375421
-
- Vascular Surgery Physician
- Salem, OR
- NPI 1508074147
-
- Ambulatory Surgical Clinic/Center
- Seattle, WA
- NPI 1417163635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1104990175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1793 13TH ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973022541",
"telephone_number": "503-362-8385",
"fax_number": "503-362-8435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1793 13TH ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973022541",
"telephone_number": "503-362-8385",
"fax_number": "503-362-8435"
}
],
"practiceLocations": [
{
"address_1": "1535 Liberty St SE",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "OR",
"postal_code": "973024345",
"country_code": "US",
"telephone_number": "503-371-8346",
"fax_number": "503-371-8334",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PITTMAN",
"first_name": "RICK",
"middle_name": "DEWITT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "OR",
"license": "MD15726",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "049148",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.