Stephen Spencer Austad, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

20A17149 Issued in CA

Practice address

123 C Ave
Lake Oswego, OR 97034-2353

Phone

(541) 316-6575

Fax

(541) 210-8913

NPI assigned

Jun 23, 2011

Last updated

Dec 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, OR, WA, AK4 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 4

Specialty

Dermatology

Education

Midwestern University, Chicago College of Osteopathic Med, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain West Derm - Blackhart PLLCGroup PAC ID 1153609813, 103 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: saustad2599502@oc.providencedirect.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.

• Mountain West Derm - Blackhart PLLC

  dba Alaska Center for Dermatology

  • Dermatology Physician
  • Anchorage, AK
  • NPI 1124670088
  Medicare reassignment Care Compare group NPD
• Clear Choice Dermatology

  dba The Skin Docs

  • Dermatology Physician
  • The Dalles, OR
  • NPI 1891327185

  WA

  Medicare reassignment NPD
• Csi Medical Group

  • MOHS-Micrographic Surgery Physician
  • San Pedro, CA
  • NPI 1871909804

  Dermatology

  Medicare reassignment NPD
• Mountain West Derm-Blackhart, PLLC

  • Dermatology Physician
  • Tigard, OR
  • NPI 1316656994
  NPD
• Mountain West Derm - Blackhart PLLC

  dba Bend Dermatology Clinic

  • Dermatology Physician
  • Bend, OR
  • NPI 1447764741
  NPD (past)

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1679869119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 E 19TH ST STE B",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583385",
            "telephone_number": "801-644-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 C AVE",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970342353",
            "telephone_number": "541-316-6575",
            "fax_number": "541-210-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTAD",
        "first_name": "STEPHEN",
        "middle_name": "SPENCER",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "20A17149",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "942",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Andrew Arville, PT
• Syed Husain Asghar, MD, DMD, BDS
• Elizabeth Lynn Ash
• Bree Michele Ashby
• Merriel Monet Ater
• Barry Michael Austin, M.D.
• Kaila Autrey, LMT
• Avamere Lake Oswego Operations Investors, LLC
• Avamere Stafford Operations, LLC
• Tristan Avery

• Dermatology Physician in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Dermatology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.