Individual provider Active NPI

Robert E Tennant, MD

  • Orthopaedic Surgery Physician
  • Portland, OR
National Provider Identifier
1508884057
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD16898 Issued in OR
Practice address
11782 SW Barnes Rd
Suite 300
Portland, OR 97225-5914
Phone
(503) 214-5200
Fax
(503) 906-6613
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 16898 OR
Interventional Pain Medicine Physician 208VP0014X MD16898 OR
Orthopaedic Surgery Physician 207X00000X MD16898 OR Primary

Addresses

Primary practice location

11782 SW Barnes Rd
Suite 300
Portland, OR 97225-5914

Mailing address

11782 SW Barnes Rd
Suite 300
Portland, OR 97225-5914
Phone (503) 214-5200

Other practice location 1

14795 SW Murray Scholls Dr Ste 109
Beaverton, OR 97007-9230
Phone (503) 906-4301 ext. 4301

Other identifiers 1

IdentifierTypeStateIssuer
020383MedicaidOR

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
I20100707000577 OR Practitioner - Orthopedic Surgery 3678471570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Georgetown University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic and Fracture Clinic PCGroup PAC ID 1052219953, 56 clinicians

Practice addresses (Care Compare)

11782 SW Barnes Rd
Suite 300
Portland, OR 97225-5933
Phone (503) 214-5200

Merit-based Incentive Payment System (MIPS)

Final score
54.33 of 100Reported as group
Quality
57.12
Promoting interoperability
0
Improvement activities
30
Cost
86.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16898ORMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Fracture Clinic PC Orthopaedic Surgery CurrentSince Aug 1, 1990 Accepting new patients
Orthopedic & Fracture Clinic PC Specialist CurrentSince Aug 1, 1990 Accepting new patients

Locations

14795 SW Murray Scholls Dr
Ste 109
Beaverton, OR 97007
Phone 5039064301 ext. 4301

11782 SW Barnes Rd
Ste 300
Portland, OR 97225
Phone (503) 214-5200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1508884057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255914",
            "telephone_number": "503-214-5200",
            "fax_number": "503-906-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255914",
            "telephone_number": "503-214-5200",
            "fax_number": "503-906-6613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14795 SW Murray Scholls Dr Ste 109",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970079230",
            "country_code": "US",
            "telephone_number": "503-906-4301 x4301",
            "fax_number": "503-906-6613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TENNANT",
        "first_name": "ROBERT",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "16898",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OR",
            "license": "MD16898",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD16898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020383",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.