Heather Conroy Selis, PNP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

093006586N2 Issued in OR

Practice address

5050 NE Hoyt St.
Suite B55
Portland, OR 97213-2984

Phone

(503) 233-5393

Fax

(503) 659-8984

NPI assigned

Jun 20, 2008

Last updated

Feb 27, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Heather Ann Conroy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 12, 2021 through Aug 12, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: hselis62305@direct.lhs.org

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.

• Oregon Pediatrics - Happy Valley, PC

  • Pediatrics Physician
  • Happy Valley, OR
  • NPI 1669794541
  NPD (past)
• Oregon Pediatrics NE Portland PC

  • Pediatrics Physician
  • Portland, OR
  • NPI 1366488090
  NPD (past)
• Oregon Pediatrics- Meridian Park, LLC

  • Pediatrics Physician
  • Tualatin, OR
  • NPI 1659317386
  NPD (past)

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1679734719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST.",
            "address_2": "SUITE B55",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132984",
            "telephone_number": "503-233-5393",
            "fax_number": "503-659-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST.",
            "address_2": "SUITE B55",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132984",
            "telephone_number": "503-233-5393",
            "fax_number": "503-659-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELIS",
        "first_name": "HEATHER",
        "middle_name": "CONROY",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "093006586N2",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "OR",
            "license": "93006586NZ",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500639814",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "CONROY",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela Self
• Mark Seligman, M.D.
• Hazel Seligson
• Katie Selin, LMT
• Stephanie S Selinger
• Kelly Selis, LCSW
• Ronald Charles Selis, DMD, PC
• Anton Selivonchick, L.AC.
• Grant Laudel Selland
• Kendyl J Selland, FNP DNP

• Pediatrics Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.