NPIMap

Individual provider Active NPI

Edward H. Rothberger, M.D.

  • Hospitalist Physician
  • Milwaukie, OR
National Provider Identifier
1356307870
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD26662 Issued in OR
Practice address
10150 SE 32ND Ave
Milwaukie, OR 97222-6516
Phone
(503) 513-8300
NPI assigned
Apr 24, 2006
Last updated
Nov 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD26662 OR
Hospitalist Physician 208M00000X MD26662 OR Primary

Addresses

Primary practice location

10150 SE 32ND Ave
Milwaukie, OR 97222-6516

Mailing address

PO Box 3158
Providence Milwaukie Hospital
Portland, OR 97208-3158

Other identifiers 1

IdentifierTypeStateIssuer
P00451467OtherORRR MEDICARE (PH&S)-PMG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070523000291 OR Practitioner - HospitalistPractitioner - Internal Medicine 0446276455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 N Providence Dr
Newberg, OR 97132-7485
Phone (503) 537-5612

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD26662ORMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon Internal Medicine Current Accepting new patients
Providence Health & Services Oregon CurrentSince May 1, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince May 1, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2007 Accepting new patients

Locations

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

Organizations & group practices 5

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 4

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": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1356307870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "address_2": "PROVIDENCE MILWAUKIE HOSPITAL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 SE 32ND AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226516",
            "telephone_number": "503-513-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBERGER",
        "first_name": "EDWARD",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD26662",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD26662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE (PH&S)-PMG",
            "identifier": "P00451467",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

Verify at the official NPI Registry.