Individual provider Active NPI

Nicholas Sytsma, MD

  • Emergency Medicine Physician
  • Clackamas, OR
National Provider Identifier
1255969085
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD214959 Issued in OR
Practice address
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone
(503) 813-2000
NPI assigned
Mar 28, 2020
Last updated
Mar 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125.075815 IL
Emergency Medicine Physician 207P00000X MD214959 OR Primary
Emergency Medicine Physician 207P00000X MD61408997 WA

Addresses

Primary practice location

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970

Mailing address

500 NE Multnomah St Ste 100
Portland, OR 97232-2031
Phone (800) 813-2000

Other practice location 1

2875 NE Stucki Ave
Hillsboro, OR 97124-5806
Phone (500) 813-2000

Other practice location 2

14406 NE 20th Ave
Vancouver, WA 98686-1448
Phone (800) 813-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnectprodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WA, OR3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20230620002071 IL Practitioner - Emergency Medicine 2264890425 Reassigns benefits to 1 organization
I20230810002070 WA Practitioner - Emergency Medicine 2264890425 Reassigns benefits to 1 organization
I20230810002119 OR Practitioner - Emergency Medicine 2264890425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.075815ILMDEmergency Medicine Physician
MD214959ORMDEmergency Medicine Physician
MD61408997WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Emergency Medicine Specialists, LLC CurrentSince May 8, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Emergency Medicine CurrentSince Jul 10, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 10, 2023 Accepting new patients

Locations

500 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 312-5000

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

2875 NE Stucki Ave
Hillsboro, OR 97124
Phone (866) 280-0511

500 NE Multnomah St
Portland, OR 97232
Phone (503) 813-4939

500 NE Multnomah St
Ste 100
Portland, OR 97232
Phone (503) 499-5200

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

14406 NE 20th Ave
Vancouver, WA 98686
Phone (360) 418-6001

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 3

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1255969085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322031",
            "telephone_number": "800-813-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158970",
            "telephone_number": "503-813-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2875 NE Stucki Ave",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971245806",
            "country_code": "US",
            "telephone_number": "500-813-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14406 NE 20th Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986861448",
            "country_code": "US",
            "telephone_number": "800-813-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SYTSMA",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-28",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.075815",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD214959",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61408997",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnectprodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4440 W 95th St",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.