Martin Athelstan Baggenstos, M.D.
Individual provider Active NPI Neurological Surgery Physician · Portland, OR
NPI 1114153194 · NPPES record last updated Nov 22, 2023
Key facts
- NPI
- 1114153194
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurological Surgery Physician 207T00000X
- License
- MD153961 (OR)
- Practice address
- 9155 SW Barnes Rd Ste 440
Portland, OR 97225-6631 - Phone
- (503) 935-8500
- Fax
- (503) 935-8505
- NPI assigned
- Jun 4, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Neurosurgery
- Education
- Tufts University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- The Oregon Clinic, PC
Practice addresses (Care Compare)
1111 NE 99TH Ave
Portland, OR 97220-9442
4805 NE Glisan
Portland, OR 97213-2933
5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673
9155 SW Barnes Rd
Suite 440
Portland, OR 97225-6631
Phone (503) 935-8500
Hospital & facility affiliations
- Providence St Vincent Medical Center
- Providence Portland Medical Center
- Providence Newberg Medical Center
- Providence Seaside Hospital
- Providence Willamette Falls Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 64 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
| Laminectomy or laminotomy (partial removal of spine bones) | 36 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110817000939 | OR | Practitioner - Neurosurgery | 3375712821 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD153961 | OR | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Oregon Clinic PC | Current |
Accepting new patients | |
| The Oregon Clinic, PC | Current |
Accepting new patients |
Locations
847 NE 19th Ave
Ste 300
Portland, OR 97232
5050 NE Hoyt St
Ste 359
Portland, OR 97213
Phone (503) 935-8501
5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673
541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801
9155 SW Barnes Rd
Ste 440
Portland, OR 97225
Phone (503) 297-3766
Interoperability endpoints
- mbaggenstos101421@oc.providencedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | MD153961 | OR | Yes |
Addresses
Primary practice location
9155 SW Barnes Rd Ste 440
Portland, OR 97225-6631
Mailing address
541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801
Other practice location 1
5050 NE Hoyt St Ste 359
Portland, OR 97213-2983
Phone (503) 935-8501
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114153194 | Medicaid | WA | |
| 500635997 | Medicaid | OR |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | referringmns@1243.direct.myezyaccess.com | The Oregon Clinic PC |
Other providers in Portland, OR
- Anna Bagaric
- Cody Alexis Bagay
- Grover Carlton Bagby Jr.
- Susan Pound Bagby
- Rachel B Bage
- Eleasha Grace Baggett
- Laura Baggett
- Nicole Baggett
- Nichole Baggott
- Christina Baghdanov
All providers in Portland, OR · Neurological Surgery Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.