Individual provider Active NPI

Elizabeth Flores, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Tualatin, OR
National Provider Identifier
1275738783
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD28446 Issued in OR
Practice address
19875 SW 65TH Ave
Tualatin, OR 97062-8353
Phone
(503) 692-7785
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD28446 OR Primary

Addresses

Primary practice location

19875 SW 65TH Ave
Tualatin, OR 97062-8353

Mailing address

3715 SW Marquam Hill Rd
Portland, OR 97239-1454
Phone (503) 692-7785

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
I20240905001291 OR Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 5294802666

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Landmark Health of Oregon LLC PastSince Oct 25, 2016 Accepting new patients

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
Cascade ManorEugene, OR, CCN 385276 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Oct 1, 2023
Oct 1, 2023

Owned or controlled facilities with NPI records 1

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1275738783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 SW MARQUAM HILL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972391454",
            "telephone_number": "503-692-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19875 SW 65TH AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628353",
            "telephone_number": "503-692-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "OR",
            "license": "MD28446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

Verify at the official NPI Registry.