NPIMap

Individual provider Active NPI

Elliot A Dobkin, DO

  • Surgery Physician
  • Portland, OR
National Provider Identifier
1124423785
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DO204060 Issued in OR
Practice address
10000 SE Main St Ste 316
Portland, OR 97216-2470
Phone
(503) 256-1575
Fax
(503) 253-9848
NPI assigned
Oct 24, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X DO204060 OR Primary

Addresses

Primary practice location

10000 SE Main St Ste 316
Portland, OR 97216-2470

Mailing address

10000 SE Main St Ste 316
Portland, OR 97216-2470
Phone (503) 256-1575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210810002091 OR Practitioner - General Surgery 9830479351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portland Adventist Medical CenterGroup PAC ID 3274908819, 273 clinicians

Practice addresses (Care Compare)

10000 SE Main St
Suite 316
Portland, OR 97216-2470
Phone (503) 256-1575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)12
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO204060ORMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Adventist Medical Center Surgery CurrentSince Jul 9, 2023 Accepting new patients
Portland Adventist Medical Center Current Accepting new patients
Portland Adventist Medical Center CurrentSince Aug 30, 2021 Accepting new patients
Portland Adventist Medical Center CurrentSince Jul 9, 2023 Accepting new patients
Portland Adventist Medical Center Past Accepting new patients

Locations

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

14450 SE Royer Rd
Damascus, OR 97089
Phone (503) 658-5521

10123 SE Market St
Portland, OR 97216
Phone (503) 251-6355

10000 SE Main St
Ste 316
Portland, OR 97216
Phone (503) 256-1575

Interoperability endpoints

  • Direct secure messaging: edobkin154418@direct.ohsu.edu

Organizations & group practices 5

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": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1124423785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST STE 316",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162470",
            "telephone_number": "503-256-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST STE 316",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162470",
            "telephone_number": "503-256-1575",
            "fax_number": "503-253-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBKIN",
        "first_name": "ELLIOT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-24",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "DO204060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.