NPIMap

Individual provider Active NPI

David Prosser, M.D.

  • Vascular & Interventional Radiology Physician
  • Salem, OR
National Provider Identifier
1174940126
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD177698 Issued in OR
Practice address
2925 Ryan Dr SE
Salem, OR 97301-9687
Phone
(503) 399-1262
NPI assigned
Mar 27, 2014
Last updated
Nov 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD177698 OR
Vascular & Interventional Radiology Physician 2085R0204X MD177698 OR Primary

Addresses

Primary practice location

2925 Ryan Dr SE
Salem, OR 97301-9687

Mailing address

1155 Mill St
Reno, NV 89502-1576

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
I20200526002303 OR Practitioner - Diagnostic Radiology 0345569372 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santiam Memorial HospitalGroup PAC ID 6103729751, shared by 8 NPIs, 128 clinicians
Salem Clinic PCGroup PAC ID 7517954514, 96 clinicians
Salem Radiology Consultants PCGroup PAC ID 0446148498, 33 clinicians
Portland ClinicGroup PAC ID 8224942867, 93 clinicians

Practice addresses (Care Compare)

1401 N 10TH Ave
Stayton, OR 97383-1311
Phone (503) 769-2175

2020 Capitol St NE
Salem, OR 97301-0644
Phone (503) 399-2424

7021 SW Canyon CRST
Portland, OR 97225-3622
Phone (844) 825-9300

800 SW 13TH Ave
Portland, OR 97205-1902
Phone 50322101612110

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Portland Clinic Laboratory Current Accepting new patients
Pacific Imaging Associates LLC Diagnostic Radiology CurrentSince Dec 1, 2024 Accepting new patients
Portland Clinic CurrentSince Dec 1, 2023 Accepting new patients
Salem Radiology Consultants PC Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Salem Clinic, PC CurrentSince Jul 1, 2020 Accepting new patients
Salem Imaging LLC Diagnostic Radiology PastSince Jul 1, 2020 Accepting new patients
Salem Health Past Accepting new patients
Portland Clinic Past Accepting new patients

Locations

2725 SW Cedar Hills Blvd
Ste 225
Beaverton, OR 97005

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

800 SW 13th Ave
Portland, OR 97205
Phone (503) 221-0161

475 S Columbia River Hwy
Saint Helens, OR 97051
Phone (503) 397-8040

1165 Union St NE
Ste 200
Salem, OR 97301

2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470

2925 Ryan Dr SE
Salem, OR 97301
Phone (503) 399-1262

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

9250 SW Hall Blvd
Tigard, OR 97223
Phone (503) 221-0161

19250 SW 65th Ave
Ste 300
Tualatin, OR 97062
Phone (503) 692-1242

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1174940126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 RYAN DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973019687",
            "telephone_number": "503-399-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSSER",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-27",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD177698",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OR",
            "license": "MD177698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.