Individual provider Active NPI

Janelle Deanne Yutzie, MD

  • Surgery Physician
  • Newberg, OR
National Provider Identifier
1720200025
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD157696 Issued in OR
Practice address
1003 Providence Dr
Ste 210
Newberg, OR 97132-7523
Phone
(503) 537-5620
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5936 KS
Surgery Physician 208600000X MD157696 OR Primary

Addresses

Primary practice location

1003 Providence Dr
Ste 210
Newberg, OR 97132-7523

Mailing address

PO Box 3158
Portland, OR 97208-3158

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
I20120809000345 OR Practitioner - General Surgery 1850468901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

1510 Division St
Suite 210
Oregon City, OR 97045-1599
Phone (503) 723-6525

Hospital & facility affiliations

  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5936KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Jun 25, 2012 Accepting new patients
Providence Health & Services Oregon Surgery CurrentSince Jun 25, 2012 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients

Locations

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

1003 N Providence Dr
Ste 210
Newberg, OR 97132
Phone (503) 537-5620

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

1510 Division St
Ste 210
Oregon City, OR 97045
Phone (503) 655-6313

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

Interoperability endpoints

  • Direct secure messaging: jyutzie140153@oc.providencedirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1720200025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 PROVIDENCE DR",
            "address_2": "STE 210",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327523",
            "telephone_number": "503-537-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUTZIE",
        "first_name": "JANELLE",
        "middle_name": "DEANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "5936",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD157696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

Verify at the official NPI Registry.