Pearl Surgicenter, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

676749.00 Issued in OR

Legal business name

PEARL SURGICENTER, LLC

Practice address

120 NW 14TH Ave
Suite 200
Portland, OR 97209-2643

Phone

(503) 771-1883

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Richard Brian Rosenfield, M.D.NPI 1912048372

Title

Medical Director

Phone

(503) 771-1883

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Pearl Surgicenter, LLC

  • Ambulatory Surgical Clinic/Center
  • Beaverton, OR
  • NPI 1972397784

  2466637343

  Same PAC ID

Listed as

Pearl Surgicenter IncCCN 38C0001070

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Pearl Surgicenter2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pearl Surgicenter, LLC

  • Ambulatory Surgical Clinic/Center
  • Beaverton, OR
  • NPI 1972397784
  NPD tax ID

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard B Rosenfield, MD

  • Gynecology Physician
  • Portland, OR
  • NPI 1912048372
  NPD Authorized official
• Brittany Roselee Allen, APRN

  • Women's Health Nurse Practitioner
  • Portland, OR
  • NPI 1669186912
  NPD
• Jade Carboy, NP

  • Women's Health Nurse Practitioner
  • Bend, OR
  • NPI 1891286944
  NPD
• Kristin Kathleen Mauer, PA C

  • Surgical Physician Assistant
  • Tualatin, OR
  • NPI 1568650828
  NPD
• Shanti I Mohling, MD

  • Gynecology Physician
  • Portland, OR
  • NPI 1184654311
  NPD
• Michael M Owens, MD

  • Gastroenterology Physician
  • Seattle, WA
  • NPI 1154327716
  NPD

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1407997125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NW 14TH AVE",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092643",
            "telephone_number": "503-771-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NW 14TH AVE",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092643",
            "telephone_number": "503-771-1883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16985 NW Cornell Rd",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970065639",
            "country_code": "US",
            "telephone_number": "503-771-1883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEARL SURGICENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "ROSENFIELD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "503-771-1883",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "676749.00",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearl Health Center,PC (Pearl Health Center)
• Pearl Health Partners, LLC (Pearl Precision Surgery)
• Kiley Anne Pearl Lawrence, MD
• Pearl Natural Health
• Pearl Natural Health LLC
• Jason Pearl
• Kristine Pearl, R.N.
• Matthew Joseph Pearl, MSW
• Alia Izabelle Pearlson, MA
• Geffan Pearlson, MD, MS

• Ambulatory Surgical Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.