Individual provider Active NPI

Robert Stevens, D.P.M.

  • Podiatrist
  • Keizer, OR
National Provider Identifier
1114927910
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DP00278 Issued in OR
Practice address
4305 River Rd N
Keizer, OR 97303-5506
Phone
(503) 363-0763
Fax
(503) 363-8154
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DP00278 OR Primary

Addresses

Primary practice location

4305 River Rd N
Keizer, OR 97303-5506

Mailing address

4305 River Rd N
Keizer, OR 97303-5506
Phone (503) 363-0763

Other identifiers 1

IdentifierTypeStateIssuer
295456MedicaidOR

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100816000546 OR Practitioner - Podiatry 1850425638 Reassigns benefits to 1 organization
Practice locations: Keizer, OR

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4305 River Rd N
Keizer, OR 97303-5506
Phone (503) 363-0763

Hospital & facility affiliations

  • Legacy Silverton Medical Center Hospital, Silverton, OR, CCN 380029

Merit-based Incentive Payment System (MIPS)

Final score
94.99 of 100Reported as individual
Quality
77.5
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue84
Removal of skin lesions15
Removal of nail tissue991
Removal or shaving of skin growth885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP00278ORMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Foot Center Inc Podiatrist CurrentSince Apr 8, 2020 Accepting new patients

Locations

4305 River Rd N
Keizer, OR 97303
Phone (503) 363-0763

Organizations & group practices 1

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 1

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1114927910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973035506",
            "telephone_number": "503-363-0763",
            "fax_number": "503-363-8154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973035506",
            "telephone_number": "503-363-0763",
            "fax_number": "503-363-8154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "ROBERT",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295456",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keizer, OR

Sources for this page

Verify at the official NPI Registry.