Individual provider Active NPI

Andrew E Pitt, MD

  • Dermatology Physician
  • Lake Oswego, OR
National Provider Identifier
1275699118
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD16159 Issued in OR
Practice address
17704 Jean Way
Suite 102
Lake Oswego, OR 97035-5497
Phone
(503) 635-9221
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD16159 OR Primary

Addresses

Primary practice location

17704 Jean Way
Suite 102
Lake Oswego, OR 97035-5497

Mailing address

17704 Jean Way
Suite 102
Lake Oswego, OR 97035-5497
Phone (503) 635-9221

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101025000595 OR Practitioner - Dermatology 4981747516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Oregon Health Sciences University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Oswego Dermatology Group PCGroup PAC ID 6204808488, 4 clinicians

Practice addresses (Care Compare)

17704 Jean Way
Suite 102
Lake Oswego, OR 97035-5585
Phone (503) 635-9221

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision118
Removal of skin lesions531
Removal of nail tissue1-10
Skin biopsy435

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Oswego Dermatology Group, PC Dermatology CurrentSince Jul 11, 1994 Accepting new patients

Locations

17704 Jean Way
Ste 102
Lake Oswego, OR 97035
Phone (503) 635-9221

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1275699118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17704 JEAN WAY",
            "address_2": "SUITE 102",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355497",
            "telephone_number": "503-635-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17704 JEAN WAY",
            "address_2": "SUITE 102",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355497",
            "telephone_number": "503-635-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITT",
        "first_name": "ANDREW",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "MD16159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.