Individual provider Active NPI

Pedro Abdala, MD

  • Surgery Physician
  • Stayton, OR
National Provider Identifier
1700415932
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD225631 Issued in OR
Practice address
1371 N 10TH Ave
Stayton, OR 97383-2037
Phone
(503) 769-3785
NPI assigned
Apr 8, 2020
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD225631 OR Primary

Addresses

Primary practice location

1371 N 10TH Ave
Stayton, OR 97383-2037

Mailing address

1371 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-3785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251222003897 OR Practitioner - General Surgery 4587089016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Oregon Health Sciences University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santiam Memorial HospitalGroup PAC ID 6103729751, 128 clinicians

Practice addresses (Care Compare)

1371 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-3785

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD225631ORMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santiam Memorial Hospital CurrentSince Sep 15, 2025 Accepting new patients
Santiam Memorial Hospital CurrentSince Sep 15, 2025 Accepting new patients
Santiam Memorial Hospital Past Accepting new patients

Locations

1371 N 10th Ave
Stayton, OR 97383
Phone (503) 769-1605

1375 N 10th Ave
Ste B
Stayton, OR 97383
Phone (503) 769-7546

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1700415932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973832037",
            "telephone_number": "503-769-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973832037",
            "telephone_number": "503-769-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDALA",
        "first_name": "PEDRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD225631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stayton, OR

Sources for this page

Verify at the official NPI Registry.