Individual provider Active NPI

Salome G Dodge, D.O.

  • Obstetrics & Gynecology Physician
  • Portland, OR
National Provider Identifier
1578990750
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
DO218530 Issued in OR
Practice address
9135 SW Barnes Rd Ste 761
Portland, OR 97225-6777
Phone
(503) 216-2602
NPI assigned
Oct 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20A16523 CA
Obstetrics & Gynecology Physician 207V00000X DO218530 OR Primary

Addresses

Primary practice location

9135 SW Barnes Rd Ste 761
Portland, OR 97225-6777

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190829002062 CA Practitioner - Obstetrics/Gynecology 8224366125 Reassigns benefits to 1 organization
I20240515003350 OR Practitioner - Obstetrics/Gynecology 8224366125 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
West Virginia School of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

9135 SW Barnes Rd
Suite 761
Portland, OR 97225-6777
Phone (503) 216-2602

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A16523CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jun 1, 2024 Accepting new patients
Wellspace Health CurrentSince Aug 31, 2019 Accepting new patients
Providence Health & Services - Oregon Obstetrics & Gynecology CurrentSince Jun 3, 2024 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 3, 2024 Accepting new patients
Wellspace Health Current Accepting new patients
Providence Health & Services - Oregon Obstetrics & Gynecology CurrentSince Jun 1, 2024 Accepting new patients
Wellspace Health CurrentSince Aug 31, 2019 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

7601 Hospital Dr
Ste 220
Sacramento, CA 95823
Phone (916) 689-3433

777 12th St
Ste 250
Sacramento, CA 95814
Phone (916) 469-4690

2433 Marconi Ave
Sacramento, CA 95821
Phone (916) 313-8455

1820 J St
Sacramento, CA 95811
Phone (916) 550-5481

9135 SW Barnes Rd
Ste 761
Portland, OR 97225
Phone (503) 216-2602

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

Interoperability endpoints

  • Direct secure messaging: sgogoberidze419221@hisp.ehr.sutterhealth.org

Organizations & group practices 9

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 3

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": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1578990750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 SW BARNES RD STE 761",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256777",
            "telephone_number": "503-216-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "SALOME",
        "middle_name": "G",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A16523",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "DO218530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.