Byron V Etta, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A166911 Issued in CA

Practice address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Phone

(503) 494-5678

Fax

(949) 732-4572

NPI assigned

May 26, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

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 2

Specialty

Emergency Medicine

Education

Oregon Health Sciences University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

U S Health Dept of Health and Human ServicesGroup PAC ID 9638081623, 98 clinicians

Rosebud Indian Health ServiceGroup PAC ID 6901704055, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• PHS Indian Hospital at Rosebud Hospital, Rosebud, SD, CCN 430084

Merit-based Incentive Payment System (MIPS)

Final score

96.38 of 100Reported as group

Quality

80.82

Promoting interoperability

91

Improvement activities

40

Cost

84.44

Merit-based Incentive Payment System (MIPS)

Final score

90.52 of 100Reported as group

Quality

68.64

Promoting interoperability

91

Improvement activities

40

Cost

86.31

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rosebud Indian Health Service

  • General Acute Care Hospital
  • Rosebud, SD
  • NPI 1194757369

  TX

  Medicare reassignment Care Compare group NPD
• US Health Dept of Health & Human Services

  • Rural Health Clinic/Center
  • Poplar, MT
  • NPI 1972694602

  TX

  Medicare reassignment Care Compare group NPD
• Cep America - California

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1548667843
  Medicare reassignment NPD
• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Chinle, AZ
  • NPI 1508800129

  TX

  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • Anaheim, CA
  • NPI 1982078150
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• DHHS PHS Naihs Chinle Comprehensive

  • Ambulatory Surgical Clinic/Center
  • Chinle, AZ
  • NPI 1922253129
  NPD
• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Tsaile, AZ
  • NPI 1538185715
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD
• Rosebud Indian Health Service

  • Ambulatory Surgical Clinic/Center
  • Rosebud, SD
  • NPI 1790955128
  NPD

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

• Rosebud Indian Health Service

  • General Acute Care Hospital
  • Rosebud, SD
  • NPI 1427419282
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1174971402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-5678",
            "fax_number": "949-732-4572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Garces Hwy",
            "address_purpose": "LOCATION",
            "city": "Delano",
            "state": "CA",
            "postal_code": "932153660",
            "country_code": "US",
            "telephone_number": "661-725-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETTA",
        "first_name": "BYRON",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-26",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A166911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trent Edward Ethridge
• Sierra Rose Etie, LMT
• Etna Mental Health Goktepe P.C.
• Youske Eto, MSW, LCSW
• Rachel Etringer, FNP-BC
• Felicia J Ette
• Idara John Ette
• Brandie Ettinger, O.T.
• Kenneth Michael Ettinger, M.D.
• Emily Anne Etzkorn, MSW

• Emergency Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.