Mark a. Petroff, MD PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

MARK A. PETROFF, MD PC

Practice address

17720 Jean Way
#100
Lake Oswego, OR 97035-5574

Phone

(503) 635-4886

Fax

(503) 635-1655

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Krista Lee Bradley

Title

Clinic Administrator

Phone

(503) 607-1300

Specialties & licenses 2

Addresses

Other names 1

• Petroff Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Mark a. Petroff, MD. PC

  • Ambulatory Surgical Clinic/Center
  • Lake Oswego, OR
  • NPI 1275607616

  5890709059

  Same PAC ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark A. Petroff, M.D.

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Lake Oswego, OR
  • NPI 1528068129
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1144365941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17720 JEAN WAY",
            "address_2": "#100",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355574",
            "telephone_number": "503-635-4886",
            "fax_number": "503-635-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17720 JEAN WAY",
            "address_2": "#100",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355574",
            "telephone_number": "503-635-4886",
            "fax_number": "503-635-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. PETROFF, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "503-607-1300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Petroff Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Raymond Marble, M.D.
• Jennifer March, MD, MS
• Sabrina J. Marcus, DC
• Margaret a Hewitt MD PC
• Marion J Darling MDPC
• Mark a. Petroff, MD. PC
• Mark Weston, MD, LLC
• Marla Klein, MD LLC
• Jennifer Maronek, OT
• Claire Anna Marquez, DPT

• Plastic Surgery Physician in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Plastic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.