Individual provider Active NPI

Sareena D Oncea, RD

  • Registered Dietitian
  • Portland, OR
National Provider Identifier
1609207406
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-D-10159487 Issued in OR
Practice address
5211 NE Glisan St
BLDG C
Portland, OR 97213-3052
Phone
(503) 215-6628
NPI assigned
Dec 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD-D-10159487 OR Primary

Addresses

Primary practice location

5211 NE Glisan St
BLDG C
Portland, OR 97213-3052

Mailing address

5211 NE Glisan St
BLDG C
Portland, OR 97213-3052
Phone (503) 215-6628

Other identifiers 1

IdentifierTypeStateIssuer
1068373OtherCOMMISSION ON DIETETIC REGISTRATION

Other names 1

  • Sareena D Smith-Bucholz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170804001990 OR Practitioner - Registered Dietitian Or Nutrition Professional 6608179353 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD-D-10159487ORMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 1, 2016 Accepting new patients

Locations

440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500

5211 NE Glisan St
Bldg C
Portland, OR 97213
Phone (503) 215-3081

Organizations & group practices 3

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": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1609207406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5211 NE GLISAN ST",
            "address_2": "BLDG C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133052",
            "telephone_number": "503-215-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 NE GLISAN ST",
            "address_2": "BLDG C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133052",
            "telephone_number": "503-215-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONCEA",
        "first_name": "SAREENA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-03",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10159487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "1068373",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAREENA",
            "last_name": "SMITH-BUCHOLZ",
            "middle_name": "D",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.