Active NPI
Mareli Coetzer, DO
- Internal Medicine Physician
- Hillsboro, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DO194322
- Practice address
- 2875 NE Stucki Ave
Hillsboro, OR 97124-5806 - Phone
- (503) 813-2000
- NPI assigned
- Mar 27, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OP61179084 | WA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | DO194322 | OR | Primary |
Addresses
Primary practice location
2875 NE Stucki Ave
Hillsboro, OR 97124-5806
Mailing address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8211
Other practice location 1
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8211
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Northwest Permanente PC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Arizona College of Osteopathic Medicine Mid Western University, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2875 NE Stucki Ave
Hillsboro, OR 97124-5806
Phone (800) 813-2000
Hospital & facility affiliations
- Kaiser Sunnyside Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO194322 | OR | MD | Internal Medicine Physician |
| OP61179084 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Internal Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Internal Medicine | Current | Accepting new patients |
Locations
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
2875 NE Stucki Ave
Hillsboro, OR 97124
Phone (866) 280-0511
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Organizations & group practices 4
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Internal Medicine, WA
-
- General Practice Physician
- Portland, OR
- NPI 1649722034
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
-
- General Practice Physician
- Portland, OR
- NPI 1982959565
Internal Medicine
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Clackamas, OR
- NPI 1124182902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654905600000",
"number": "1760987192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-8211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2875 NE STUCKI AVE",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971245806",
"telephone_number": "503-813-2000"
}
],
"practiceLocations": [
{
"address_1": "3181 SW Sam Jackson Park Rd",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972393011",
"country_code": "US",
"telephone_number": "503-494-8211",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COETZER",
"first_name": "MARELI",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-27",
"last_updated": "2022-06-11",
"certification_date": "2022-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "OP61179084",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "DO194322",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Northwest Permanente PC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "2875 NE Stucki Ave",
"city": "Hillsboro",
"state": "OR",
"country_code": "US",
"postal_code": "971245806",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; 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.