NPIMap

Individual provider Active NPI

Sajal C Dutta, MD

  • Urology Physician
  • Portland, OR
National Provider Identifier
1528055548
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD23632 Issued in OR
Practice address
501 N Graham St Ste 420
Portland, OR 97227-2006
Phone
(503) 288-7303
Fax
(503) 288-3806
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD23632 OR Primary

Addresses

Primary practice location

501 N Graham St Ste 420
Portland, OR 97227-2006

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other practice location 1

19250 SW 65th Ave Ste 235
Tualatin, OR 97062-7745
Phone (503) 692-4820

Other practice location 2

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200

Other identifiers 3

IdentifierTypeStateIssuer
286467MedicaidOR
8383143MedicaidWA
2147140MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_cas_front_desk_pool12223192@oc.providencedirect.org The Oregon Clinic PC

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
I20090220000280 OR Practitioner - Urology 2365507654 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

1111 NE 99TH Ave
Portland, OR 97220-9442

19250 SW 65TH Ave
Suite 235
Tualatin, OR 97062-7745
Phone (503) 692-4820

501 N Graham St
Suite 420
Portland, OR 97227-2006
Phone (503) 288-7303

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

Hospital & facility affiliations

  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Legacy Silverton Medical Center Hospital, Silverton, OR, CCN 380029

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as individual
Quality
74
Promoting interoperability
91
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection31

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2015 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Apr 22, 2025 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Apr 22, 2025 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2015 Accepting new patients
Legacy Mount Hood Medical Center Current Accepting new patients
The Oregon Clinic PC CurrentSince Jul 1, 2015 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Apr 22, 2025 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Apr 22, 2025 Accepting new patients
The Oregon Clinic, PC CurrentSince Jul 1, 2015 Accepting new patients
Legacy Meridian Park Hospital Past Accepting new patients

Locations

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

24900 SE Stark St
Ste 103
Gresham, OR 97030
Phone (503) 665-4278

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

501 N Graham St
Ste 420
Portland, OR 97227
Phone (503) 288-7303

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

847 NE 19th Ave
Ste 300
Portland, OR 97232

19250 SW 65th Ave
Ste 235
Tualatin, OR 97062
Phone (503) 692-1470

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Interoperability endpoints

  • Direct secure messaging: sdutta101535@oc.providencedirect.org

Organizations & group practices 11

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 9

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1528055548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 420",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272006",
            "telephone_number": "503-288-7303",
            "fax_number": "503-288-3806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19250 SW 65th Ave Ste 235",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970627745",
            "country_code": "US",
            "telephone_number": "503-692-4820",
            "fax_number": "503-612-0793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2801 N Gantenbein Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271623",
            "country_code": "US",
            "telephone_number": "503-413-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUTTA",
        "first_name": "SAJAL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD23632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286467",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8383143",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2147140",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_cas_front_desk_pool12223192@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "501 N Graham St Ste 420",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972272006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.