NPIMap

Individual provider Active NPI

Robert L. Oksenholt, D.O.

  • Internal Medicine Physician
  • Lincoln City, OR
National Provider Identifier
1548208929
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO17321 Issued in OR
Practice address
3489 NW Highway 101
Lincoln City, OR 97367-4959
Phone
(541) 614-1515
Fax
(541) 614-1516
NPI assigned
Jun 4, 2006
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO17321 OR Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X DO17321 OR
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 185523 NY
Pulmonary Disease Physician 207RP1001X DO17321 OR

Addresses

Primary practice location

3489 NW Highway 101
Lincoln City, OR 97367-4959

Mailing address

3489 NW Highway 101
Lincoln City, OR 97367-4959
Phone (541) 614-1515

Other practice location 1

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1550

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040202000446 OR Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 1052214368 Practice locations: Lincoln City, OR
I20140418000124 NY Practitioner - Critical Care (Intensivists) 1052214368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3489 NW Hwy 101
Lincoln City, OR 97367-4959

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
185523NYMDCritical Care Medicine (Internal Medicine) Physician
19653ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter's Hospital of the City of Albany Internal Medicine CurrentSince Jun 1, 2013 Accepting new patients
St. Peter's Hospital of the City of Albany Internal Medicine CurrentSince Jun 1, 2013 Accepting new patients
Ut Physicians Internal Medicine Past Accepting new patients
Ut Physicians Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

Interoperability endpoints

  • Direct secure messaging: roksenholt789371@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1548208929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3489 NW HIGHWAY 101",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973674959",
            "telephone_number": "541-614-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3489 NW HIGHWAY 101",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973674959",
            "telephone_number": "541-614-1515",
            "fax_number": "541-614-1516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 S Manning Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-1550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKSENHOLT",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO17321",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "DO17321",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "185523",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "DO17321",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lincoln City, OR

Sources for this page

Verify at the official NPI Registry.