NPIMap

Individual provider Active NPI

Kevin R Sellars, MD

  • Internal Medicine Physician
  • Newberg, OR
National Provider Identifier
1396778916
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD23180 Issued in OR
Practice address
1003 Providence Dr
Suite 110
Newberg, OR 97132-7521
Phone
(503) 537-5900
Fax
(503) 537-1820
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD23180 OR Primary

Addresses

Primary practice location

1003 Providence Dr
Suite 110
Newberg, OR 97132-7521

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other identifiers 1

IdentifierTypeStateIssuer
287499MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ksellars117778@oc.providencedirect.org
Direct Messaging Address ksellars117778@oc.providencedirect.org

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
I20041213000259 OR Practitioner - Internal Medicine 8921065897 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 N Providence Dr
Suite 120
Newberg, OR 97132-7582
Phone (503) 537-5900

1001 N Providence Dr
Newberg, OR 97132-7485
Phone (503) 537-1555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23180ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2005 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Aug 6, 2001 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2005 Accepting new patients
Providence Health & Services - Oregon Internal Medicine Past Accepting new patients

Locations

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

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

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

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

1000 N Providence Dr
Ste 120
Newberg, OR 97132
Phone (503) 537-5700

1003 N Providence Dr
Ste 110
Newberg, OR 97132

1515 E Portland Rd
Newberg, OR 97132
Phone (503) 537-1818

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

1321 NE 99th Ave
Ste 100
Portland, OR 97220
Phone (503) 215-4050

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

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1396778916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 PROVIDENCE DR",
            "address_2": "SUITE 110",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327521",
            "telephone_number": "503-537-5900",
            "fax_number": "503-537-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLARS",
        "first_name": "KEVIN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD23180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287499",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksellars117778@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1000 N Providence Dr Ste 120",
            "city": "Newberg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971327582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksellars117778@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1001 N Providence Dr",
            "city": "Newberg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971327485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

Verify at the official NPI Registry.