Individual provider Active NPI

Ellen Marie Raney, M.D.

  • Pediatric Orthopaedic Surgery Physician
  • Portland, OR
National Provider Identifier
1407946577
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
MD154890 Issued in OR
Practice address
3101 SW Sam Jackson Park Rd
Portland, OR 97239-3009
Phone
(503) 221-3424
Fax
(503) 221-3490
NPI assigned
Oct 12, 2006
Sex
Female
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
Pediatric Orthopaedic Surgery Physician 207XP3100X 10290 HI
Pediatric Orthopaedic Surgery Physician 207XP3100X MD154890 OR Primary

Addresses

Primary practice location

3101 SW Sam Jackson Park Rd
Portland, OR 97239-3009

Mailing address

PO Box 8500, Lockbox 7642
Shriners Hospitals for Children Portland
Philadelphia, PA 19178-7642
Phone (813) 281-8115

Other identifiers 1

IdentifierTypeStateIssuer
MD154890OtherORLICENSE

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
I20131106001149 OR Practitioner - Orthopedic Surgery 2466687082 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10290HIMDPediatric Orthopaedic Surgery Physician
MD154890ORMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Shriners Hospitals for Children CurrentSince Sep 9, 2023 Accepting new patients

Locations

1310 Punahou St
Honolulu, HI 96826
Phone (808) 941-4466

3101 SW Sam Jackson Park Rd
#R
Portland, OR 97239
Phone (503) 241-5090

3101 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 221-3424

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1407946577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500, LOCKBOX 7642",
            "address_2": "SHRINERS HOSPITALS FOR CHILDREN PORTLAND",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "813-281-8115",
            "fax_number": "813-281-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393009",
            "telephone_number": "503-221-3424",
            "fax_number": "503-221-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANEY",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "HI",
            "license": "10290",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "OR",
            "license": "MD154890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MD154890",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.