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Organization Active NPI

Altea Medical Oregon LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Portland, OR
National Provider Identifier
1184451254
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
ALTEA MEDICAL OREGON LLC
Practice address
127 NE 102ND Ave Ste a
Portland, OR 97220-4152
Phone
(971) 978-1268
NPI assigned
Sep 13, 2024
Last updated
Apr 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Mary Belen Arndt
Title
Director of Billing
Phone
(775) 287-3290

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary
Physical Medicine & Rehabilitation Physician 208100000X NU

Addresses

Primary practice location

127 NE 102ND Ave Ste a
Portland, OR 97220-4152

Mailing address

400 E Rivulon Blvd Ste 103
Gilbert, AZ 85297-0096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241023002539 OR Part B Supplier - Clinic/Group Practice 7315470895 Receives reassigned benefits from 52 practitioners
Practice locations: Clatskanie, OR; Tigard, OR; Springfield, OR; Portland, OR; Oregon City, OR; Eugene, OR; Gresham, OR; John Day, OR…

National Provider Directory

National Provider Directory

Locations

389 W 29th Ave
Eugene, OR 97405
Phone (541) 683-3618

1250 SE Roberts Ave
Gresham, OR 97080
Phone (503) 667-5430

10948 SE Boise St
Portland, OR 97266
Phone (503) 483-2204

127 NE 102nd Ave
Ste A
Portland, OR 97220
Phone (541) 998-2395

34 NE 20th Ave
Portland, OR 97232
Phone (503) 231-0276

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gateway Care and RetirementPortland, OR, CCN 385268 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Oct 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1184451254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E RIVULON BLVD STE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 NE 102ND AVE STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204152",
            "telephone_number": "971-978-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTEA MEDICAL OREGON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-13",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "ARNDT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "BELEN",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "775-287-3290"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.