Individual provider Active NPI

Carter C. Wystrach, MD, MPH

  • Emergency Medicine Physician
  • Clackamas, OR
National Provider Identifier
1639411895
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD180923 Issued in OR
Practice address
Kaiser Permanente Sunnyside Medical Center
10180 SE Sunnyside Rd.
Clackamas, OR 97015
Phone
(503) 652-2880
NPI assigned
Mar 26, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A133628 CA
Emergency Medicine Physician 207P00000X MD180923 OR Primary

Addresses

Primary practice location

Kaiser Permanente Sunnyside Medical Center
10180 SE Sunnyside Rd.
Clackamas, OR 97015

Mailing address

Kaiser Permanente Sunnyside Medical Center
10180 SE Sunnyside Rd.
Clackamas, OR 97015
Phone (503) 652-2880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR, WA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20170210001339 CA Practitioner - Emergency Medicine 7113200478 Reassigns benefits to 1 organization
I20170823004460 OR Practitioner - Emergency Medicine 7113200478 Reassigns benefits to 1 organization
I20230906001919 WA Practitioner - Emergency Medicine 7113200478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Francisco Emergency Medical AssociatesGroup PAC ID 5698662518, 74 clinicians

Practice addresses (Care Compare)

1101 Van Ness Ave
San Francisco, CA 94109-6919
Phone (415) 600-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133628CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 24, 2017 Accepting new patients
San Francisco Emergency Medical Associates Emergency Medicine CurrentSince May 1, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Emergency Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Emergency Medicine CurrentSince Jul 23, 2023 Accepting new patients

Locations

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

45 Castro St
San Francisco, CA 94114
Phone (415) 241-5695

1101 Van Ness Ave
San Francisco, CA 94109
Phone (415) 485-8824

3555 Cesar Chavez
San Francisco, CA 94110
Phone (415) 485-8824

30 Mark West Springs Rd
Santa Rosa, CA 95403
Phone (707) 576-4000

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: cwystrach745443@hisp.ehr.sutterhealth.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 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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1639411895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KAISER PERMANENTE SUNNYSIDE MEDICAL CENTER",
            "address_2": "10180 SE SUNNYSIDE RD.",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "503-652-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KAISER PERMANENTE SUNNYSIDE MEDICAL CENTER",
            "address_2": "10180 SE SUNNYSIDE RD.",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "503-652-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSTRACH",
        "first_name": "CARTER",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2025-06-02",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A133628",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD180923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.