Active NPI
Abigail Elizabeth Vautrain, M.D.
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Gresham, OR
National Provider Identifier
1710208921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice and Palliative Medicine (Internal Medicine) Physician
- License
- 85866-20
- Practice address
- 25050 SE Stark St Ste 250
Gresham, OR 97030-3388 - Phone
- (503) 413-6862
- NPI assigned
- Jun 22, 2010
- Last updated
- Oct 13, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | MD172130 | OR | |
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | 85866-20 | WI | Primary |
Addresses
Primary practice location
25050 SE Stark St Ste 250
Gresham, OR 97030-3388
Mailing address
600 Highland Ave
Madison, WI 53792-0001
Other practice location 1
600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 096511 | Medicaid | OR | |
| 22959 | Medicaid | OR |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250708000645 | OR | Order and Referring Only - Internal Medicine | 3173767019 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85866-20 | WI | MD | Hospice and Palliative Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Meridian Park Hospital | Past | Accepting new patients |
Interoperability endpoints
- avautrain13283@direct.lhs.org
Organizations & group practices 1
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.
-
- Hospitalist Physician
- Tualatin, OR
- NPI 1023305034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791849600000",
"number": "1710208921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537920001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25050 SE STARK ST STE 250",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970303388",
"telephone_number": "503-413-6862"
}
],
"practiceLocations": [
{
"address_1": "600 Highland Ave",
"address_purpose": "LOCATION",
"city": "Madison",
"state": "WI",
"postal_code": "537920001",
"country_code": "US",
"telephone_number": "608-263-6400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAUTRAIN",
"first_name": "ABIGAIL",
"middle_name": "ELIZABETH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-22",
"last_updated": "2026-10-13",
"certification_date": "2026-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": "OR",
"license": "MD172130",
"primary": false
},
{
"code": "207RH0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": "WI",
"license": "85866-20",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "096511",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "22959",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.