Theodore David Pawlik, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

MD27961 Issued in OR

Practice address

501 N Graham St
Suite 265
Portland, OR 97227-2000

Phone

(503) 282-7002

Fax

(503) 280-1290

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  NPD (past)
• Northwest Newborn Specialists PC

  • Neonatal-Perinatal Medicine Physician
  • Orange, CA
  • NPI 1235135302
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1154483402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE 265",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272000",
            "telephone_number": "503-282-7002",
            "fax_number": "503-280-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE 265",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272000",
            "telephone_number": "503-282-7002",
            "fax_number": "503-280-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLIK",
        "first_name": "THEODORE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036103541",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OR",
            "license": "MD27961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218504",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Kabryn Pavlovich, LCSW
• Evgeny Pavlushkov, MD, PHD, FRCR
• Ta May Paw
• Anushka Pawashe
• Evan Pawlak
• Yvette Pawlowski, MA, BCBA
• Jason Pawlowsky, D.O.
• Elizabeth Barbara Paxson, L.M.T.
• Georgia Paxson
• Dain Cameron Paxton I, DMD

• Neonatal-Perinatal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Neonatal-Perinatal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.