Individual provider Active NPI

Robert Paulsen Michael, M.D.

  • Pediatrics Physician
  • Lebanon, OR
National Provider Identifier
1346653722
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
184207 Issued in OR
Practice address
675 N 5TH St
Lebanon, OR 97355-2875
Phone
(541) 451-6282
Fax
(541) 812-2038
NPI assigned
Jun 3, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 184207 OR Primary
Pediatrics Physician 208000000X 0116026909 VA

Addresses

Primary practice location

675 N 5TH St
Lebanon, OR 97355-2875

Mailing address

PO Box 1193
Corvallis, OR 97339-1193

Other practice location 1

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-7834

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmichael137084@samhealth.direct-ci.com

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
I20171107003556 OR Practitioner - Pediatric Medicine 7810253812 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Howard University College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Valley Healthcare IncGroup PAC ID 2769391523, 143 clinicians

Practice addresses (Care Compare)

400 N Santiam Hwy
Lebanon, OR 97355
Phone (541) 451-6388

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
184207ORMDPediatrics Physician
0116026909VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital CurrentSince Mar 20, 2020 Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Dec 1, 2021 Accepting new patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
Albany General Hospital CurrentSince Mar 20, 2020 Accepting new patients
Samaritan North Lincoln Hospital Current Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Oct 21, 2021 Accepting new patients
Samaritan Pacific Health Services, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Dec 1, 2021 Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Oct 21, 2021 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Sep 9, 2017 Accepting new patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Dec 1, 2021 Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Sep 9, 2017 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients

Locations

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

777 NW 9th St
Ste 102
Corvallis, OR 97330
Phone (541) 768-6769

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

675 N 5th St
Lebanon, OR 97355
Phone (541) 451-6282

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

Interoperability endpoints

  • Direct secure messaging: rmichael137084@samhealth.direct-ci.com

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346653722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1193",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N 5TH ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973552875",
            "telephone_number": "541-451-6282",
            "fax_number": "541-812-2038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-776-7834",
            "fax_number": "703-776-4323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "ROBERT",
        "middle_name": "PAULSEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-03",
        "last_updated": "2022-07-21",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "184207",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0116026909",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmichael137084@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "675 N 5th St",
            "city": "Lebanon",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973552875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

Verify at the official NPI Registry.