Active NPI
Steven Mark Rotter, MD
- Internal Medicine Physician
- Portland, OR
National Provider Identifier
1558447722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 15275
- Practice address
- 1820 SW Vermont St
Ste I
Portland, OR 97219-1945 - Phone
- (503) 977-1006
- Fax
- (503) 328-0281
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 15275 | OR | Primary |
Addresses
Primary practice location
1820 SW Vermont St
Ste I
Portland, OR 97219-1945
Mailing address
1820 SW Vermont St
Ste I
Portland, OR 97219-1945
Phone (503) 977-1006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15275 | OR | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Natural Medicine, Inc | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/22798/brand/1/csg/1/fhir/r4
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Portland, OR
- NPI 1043317928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558447722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1820 SW VERMONT ST",
"address_2": "STE I",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972191945",
"telephone_number": "503-977-1006",
"fax_number": "503-328-0281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1820 SW VERMONT ST",
"address_2": "STE I",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972191945",
"telephone_number": "503-977-1006",
"fax_number": "503-328-0281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTTER",
"first_name": "STEVEN",
"middle_name": "MARK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "15275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.