Individual provider Active NPI

Sarah B Oltman, PA-C

  • Physician Assistant
  • Salem, OR
National Provider Identifier
1255952164
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA206796 Issued in OR
Practice address
2480 Liberty St NE Ste 110
Salem, OR 97301-8381
Phone
(971) 300-0654
NPI assigned
May 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA206796 OR
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA206796 OR Primary

Addresses

Primary practice location

2480 Liberty St NE Ste 110
Salem, OR 97301-8381

Mailing address

7126 N Kellogg St
Portland, OR 97203-3963

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210928002826 OR Practitioner - Physician Assistant 6608273016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Robert Olsen MD LLCGroup PAC ID 7517354517, 25 clinicians

Practice addresses (Care Compare)

13535 SW 72ND Ave
Suite 170
Portland, OR 97223-8074
Phone (971) 300-0654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA206796ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Santiam Memorial Hospital CurrentSince Sep 27, 2021 Accepting new patients
Santiam Memorial Hospital CurrentSince Sep 27, 2021 Accepting new patients
Robert Olsen MD Washington PC PastSince Oct 6, 2024 Accepting new patients
Santiam Memorial Hospital Past Accepting new patients

Locations

1375 N 10th Ave
Ste B
Stayton, OR 97383
Phone (503) 769-7546

1401 N 10th Ave
Ste 200
Stayton, OR 97383
Phone (503) 769-7151

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

Interoperability endpoints

  • Direct secure messaging: bestmindbehavioralhealth.saraholtman@151547.advancedmd-direct.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1255952164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7126 N KELLOGG ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972033963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LIBERTY ST NE STE 110",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973018381",
            "telephone_number": "971-300-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLTMAN",
        "first_name": "SARAH",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA206796",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA206796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.